Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 5702 | OH |
NPI | 1326396813 |
---|---|
Provider Name | Nicole Martin |
First Address | Cincinnati, OH 45239-4525 |
Second Address | Cincinnati, OH 45203-1519 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2012 |
Last Update Date | 15/08/2012 |