Individual
MS. BRENDA ANN MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LOTR
Contact information
Practice address
23515 HIGHWAY 190, MANDEVILLE, LA 70448-7334
(985) 626-6649
Mailing address
513 BON TEMPS ROULE, MANDEVILLE, LA 70471-2504
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Z10469
—
225X00000X
Occupational Therapist
Primary
Z10469
LA
Other
Enumeration date
05/16/2019
Last updated
05/16/2019
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