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Individual

ASHLEY MARTINEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
299 HALLOCK AVE, PORT JEFFERSON STATION, NY 11776-1217
(631) 473-4284
Mailing address
24 DOUGLASS ST, BRENTWOOD, NY 11717-1811
(631) 748-0996

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
174400000X
Specialist
224Z00000X
Occupational Therapy Assistant
225100000X
Physical Therapist
225200000X
Physical Therapy Assistant
Primary
225X00000X
Occupational Therapist
231H00000X
Audiologist
235500000X
Speech/Language/Hearing Specialist/Technologist
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
10/07/2022
Last updated
10/07/2022
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