Individual
MS. KIM ELLEN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTL CHT
Contact information
Practice address
3466 PINE RIDGE RD STE A, NAPLES, FL 34109-3883
(239) 261-2663
(239) 262-5633
Mailing address
3466 PINE RIDGE RD STE A, NAPLES, FL 34109-3883
(239) 261-2663
(239) 262-5633
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0244
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AZ0460790
BCBS
—
Enumeration date
04/21/2006
Last updated
08/25/2021
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