Provider Demographics
NPI:1508197211
Name:DAVEY, MARTHA SMITH (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:MARTHA
Middle Name:SMITH
Last Name:DAVEY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 WINONA ST
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-4635
Mailing Address - Country:US
Mailing Address - Phone:978-535-5605
Mailing Address - Fax:
Practice Address - Street 1:167 WINONA ST
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-4635
Practice Address - Country:US
Practice Address - Phone:978-535-5605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-20
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA102225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist