Individual
MRS. DEBRA DIANN MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
105036 S 3570 RD, PRAGUE, OK 74864-6454
(405) 567-7386
Mailing address
105036 S 3570 RD, PRAGUE, OK 74864-6454
(405) 567-7386
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1140
OK
Other
Enumeration date
06/24/2011
Last updated
01/14/2021
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