Provider Demographics
NPI:1629820832
Name:MARTIN, EMILEE HOPE (COTA/L)
Entity Type:Individual
Prefix:
First Name:EMILEE
Middle Name:HOPE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 4H CAMP DR
Mailing Address - Street 2:
Mailing Address - City:DAWSON SPRINGS
Mailing Address - State:KY
Mailing Address - Zip Code:42408-8801
Mailing Address - Country:US
Mailing Address - Phone:270-625-8462
Mailing Address - Fax:
Practice Address - Street 1:1710 HIGHWAY 121 BYP N STE K
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-8762
Practice Address - Country:US
Practice Address - Phone:270-767-6397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY290752224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant