MEDICARE: TAMIKA JAVON MARTIN SLP-MA-CCC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	13937	NC

General Provider Information

NPI Number	:	1871330829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMIKA JAVON MARTIN SLP-MA-CCC

Provider Business Mailing Address
First Line	:	2300 NW 42ND AVE
Second Line	:
City	:	LAUDERHILL
State	:	FL
Zip	:	33313-3625
Country	:	US
Telephone Number	:	951-999-1201
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 LOGANS MANOR DR
Second Line	:
City	:	HOLLY SPRINGS
State	:	NC
Zip	:	27540-9739
Country	:	US
Telephone Number	:	951-999-1201
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2024
Last Update Date	:	04/10/2026

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Directions to “ TAMIKA JAVON MARTIN SLP-MA-CCC” Practice Location

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