Healthcare Provider Details

I. General information

NPI: 1831016294
Provider Name (Legal Business Name): JANEL MONIQUE MARTIN LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11285 ELKINS RD STE J2
ROSWELL GA
30076-1264
US

IV. Provider business mailing address

707 FRANKLIN GTWY SE APT 4-2
MARIETTA GA
30067-2819
US

V. Phone/Fax

Practice location:
  • Phone: 773-236-4078
  • Fax:
Mailing address:
  • Phone: 773-236-4078
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT015026
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: