Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | OT14088 | FL |
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | OT14088 | FL |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OT14088 | FL |
NPI | 1164502860 |
---|---|
Provider Name | Mrs. Kerri Jane Martin |
First Address | Tampa, FL 33612-4745 |
Second Address | Tampa, FL 33612-4745 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 27/04/2016 |