Provider Demographics
NPI:1073131272
Name:MARTENS, ALAINA JAYNE (SLP)
Entity Type:Individual
Prefix:
First Name:ALAINA
Middle Name:JAYNE
Last Name:MARTENS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 DWIGHT ST APT 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-3329
Mailing Address - Country:US
Mailing Address - Phone:402-671-2873
Mailing Address - Fax:
Practice Address - Street 1:100 CUMMINGS CTR STE 350G
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-6136
Practice Address - Country:US
Practice Address - Phone:978-712-0003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-14
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA77646235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist