Provider Demographics
NPI:1043407455
Name:MARTIN, BELINDA KAY (COTA)
Entity Type:Individual
Prefix:
First Name:BELINDA
Middle Name:KAY
Last Name:MARTIN
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7733 FORSYTH BLVD
Mailing Address - Street 2:SUITE 2300
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63105-1817
Mailing Address - Country:US
Mailing Address - Phone:800-677-1202
Mailing Address - Fax:866-482-3001
Practice Address - Street 1:7733 FORSYTH BLVD
Practice Address - Street 2:SUITE 2300
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63105-1817
Practice Address - Country:US
Practice Address - Phone:800-677-1202
Practice Address - Fax:866-482-3001
Is Sole Proprietor?:No
Enumeration Date:2007-09-29
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1664224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant