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NPI Code Detail

MEDICARE: KATHERINE BLAIR MARTIN

MEDICARE: KATHERINE BLAIR MARTIN
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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1972897882
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE BLAIR MARTIN
Provider Business Mailing Address
First Line : 3232 CORAL WAY
Second Line : UNIT 604
City : CORAL GABLES
State : FL
Zip : 33145-3184
Country : US
Telephone Number : 804-398-8899
Fax Number :
Provider Business Practice Location Address
First Line : 3520 OAKS WAY APT 904
Second Line :
City : POMPANO BEACH
State : FL
Zip : 33069-5387
Country : US
Telephone Number : 804-398-8899
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2011
Last Update Date : 06/08/2011

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Directions to “ KATHERINE BLAIR MARTIN ” Practice Location

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