Provider Demographics
NPI:1346456233
Name:MARTIN, SHERI LYNN (MS,OTR/L, LSVT)
Entity type:Individual
Prefix:
First Name:SHERI
Middle Name:LYNN
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MS,OTR/L, LSVT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4250 20TH ST SE
Mailing Address - Street 2:
Mailing Address - City:PETTIBONE
Mailing Address - State:ND
Mailing Address - Zip Code:58475-9352
Mailing Address - Country:US
Mailing Address - Phone:701-771-8949
Mailing Address - Fax:
Practice Address - Street 1:4250 20TH ST SE
Practice Address - Street 2:
Practice Address - City:PETTIBONE
Practice Address - State:ND
Practice Address - Zip Code:58475-9352
Practice Address - Country:US
Practice Address - Phone:701-771-8949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND953225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1459172Medicaid
ND26100OtherBCBS