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Contact Information

KELLY MARTIN, COTA
12111 N 66TH AVE
GLENDALE, AZ85304-1625
 Phone: 573-569-0144
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Rehabilitation Practitioner

225400000X
Indicates primary specialty

NPI Profile & details for KELLY MARTIN · (Female)

NPI # 1316330178
Status Active
Credentials COTA (Certified Occupational Therapy Assistant)
Entity Individual
Enumeration date 03/17/2015
Last updated 03/17/2015 - About 11 years ago
Sole proprietor 1 No
Identifiers
  • AZ License # 5909
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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