Individual
MISS JESSICA LYNN MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
101 S AVASOLO ST, RIO GRANDE CITY, TX 78582-4507
(956) 487-8100
(956) 487-8155
Mailing address
101 S AVASOLO ST, RIO GRANDE CITY, TX 78582-4507
(956) 487-8100
(956) 487-8155
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
111297
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
210644501
—
TX
Enumeration date
12/22/2006
Last updated
03/20/2012
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