Individual
JEANINE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2930 146TH ST W APT 239, ROSEMOUNT, MN 55068
(410) 790-5814
Mailing address
2930 146TH ST W APT 239, ROSEMOUNT, MN 55068-3718
(410) 790-5814
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
12/13/2013
Last updated
12/13/2013
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