Provider Demographics
NPI:1740005412
Name:MARTIN, ANNA KATHERINE (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:KATHERINE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:651 MAIN ST STE 147
Mailing Address - Street 2:
Mailing Address - City:GARDENDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35071-2790
Mailing Address - Country:US
Mailing Address - Phone:659-246-5150
Mailing Address - Fax:
Practice Address - Street 1:651 MAIN ST STE 147
Practice Address - Street 2:
Practice Address - City:GARDENDALE
Practice Address - State:AL
Practice Address - Zip Code:35071-2790
Practice Address - Country:US
Practice Address - Phone:659-246-5150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6366225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics