Individual
MIRANDA SHAY MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
5052 MAID MARION CT, ASHLAND, KY 41101-6822
(606) 922-0850
Mailing address
5052 MAID MARION CT, ASHLAND, KY 41101-6822
(606) 922-0850
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
C2389
WV
Other
Enumeration date
07/17/2024
Last updated
07/17/2024
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