Individual
JEFFREY BRYAN SISON MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
1024 GINSENG CT, HENDERSON, NV 89052-5008
(818) 645-6082
Mailing address
1024 GINSENG CT, HENDERSON, NV 89052-5008
(818) 645-6082
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
12-0281
NV
225XF0002X
Feeding, Eating & Swallowing Occupational Therapist
12-0281
NV
225XP0019X
Physical Rehabilitation Occupational Therapist
12-0281
NV
225XP0200X
Pediatric Occupational Therapist
Primary
12-0281
NV
Other
Enumeration date
12/05/2012
Last updated
12/05/2012
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