Individual
NANISHA MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1509 ATKINSON RD STE 1100, LAWRENCEVILLE, GA 30043-7986
(770) 995-2379
Mailing address
4003 INDIAN MANOR DR, STONE MOUNTAIN, GA 30083-4627
(770) 608-9011
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT007251
GA
Other
Enumeration date
02/04/2019
Last updated
02/04/2019
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