Individual
MELINDA MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
195 MATTIE M KELLY BLVD, DESTIN, FL 32541-2811
(850) 654-4588
Mailing address
195 MATTIE M KELLY BLVD, DESTIN, FL 32541-2811
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA14213
FL
Other
Enumeration date
10/22/2015
Last updated
10/22/2015
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