Individual
JACQUELINE SUE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS, MS
Contact information
Practice address
1001 SYCAMORE LN, DANVILLE, IN 46122-1474
(317) 745-7503
Mailing address
9123 N COUNTY ROAD 900 E, SHELBURN, IN 47879-8155
(812) 249-2862
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
12/09/2018
Last updated
12/09/2018
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