Individual
MRS. MARTHA JEAN O'BRIEN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MS SLP/CCC
Contact information
Practice address
1412 W 3RD ST, FARMVILLE, VA 23901-2648
(434) 392-1596
(434) 392-5201
Mailing address
PO BOX 468, FARMVILLE, VA 23901-0468
(434) 392-4910
(434) 392-8793
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202001292
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14190
OPTIMA HEALTH
VA
01
—
2111268
MAMSI
VA
01
—
21148
UNICARE
VA
01
—
23591
CARE NET
VA
01
—
3182528
AETNA
VA
01
—
386774
BLUE CROSS BLUE SHIELD
VA
01
—
65549
SOUTHERN HEALTH
VA
Enumeration date
08/26/2005
Last updated
07/08/2007
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