MEDICARE: MARTIN'S ACADEMY FOR THE ENERGIZED AND TALENTED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	224Z00000X	Occupational Therapy Assistant
2	101YS0200X	School Counselor
3	103TB0200X	Cognitive & Behavioral Psychologist
4	225100000X	Physical Therapist
5	103TM1800X	Intellectual & Developmental Disabilities Psychologist
6	225A00000X	Music Therapist
7	2251P0200X	Pediatric Physical Therapist
8	225200000X	Physical Therapy Assistant
9	225X00000X	Occupational Therapist
10	225XP0200X	Pediatric Occupational Therapist
11	2355S0801X	Speech-Language Assistant
12	235Z00000X	Speech-Language Pathologist
13	251S00000X	Community/Behavioral Health Agency
14	390200000X	Student in an Organized Health Care Education/Training Program
15	222Q00000X	Developmental Therapist

General Provider Information

NPI Number	:	1174999742
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARTIN'S ACADEMY FOR THE ENERGIZED AND TALENTED

Provider Business Mailing Address
First Line	:	4138 ALLISON RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77048-4603
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4138 ALLISON RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77048-4603
Country	:	US
Telephone Number	:	832-659-2419
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. TABITHA L MARTIN
Credential	:
Telephone Number	:	832-659-2419

Provider Enumeration Date	:	08/18/2015
Last Update Date	:	08/18/2015

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Directions to “MARTIN'S ACADEMY FOR THE ENERGIZED AND TALENTED ” Practice Location

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