Individual
REBECCA P MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2030 CHILHOWEE MEDICAL PARK, MARYVILLE, TN 37804-5285
(865) 982-3400
Mailing address
PO BOX 5209, MARYVILLE, TN 37802-5209
(865) 982-3400
(865) 238-2034
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
995
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
995
BOARD OF COMMUNICATION DISORDERS AND SCIENCES
TN
Enumeration date
02/14/2018
Last updated
02/14/2018
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