Provider Demographics
NPI:1760735104
Name:MEYER, MARTHA A (OTR/L)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:A
Last Name:MEYER
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 1:7413 N CEDAR AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-3833
Mailing Address - Country:US
Mailing Address - Phone:559-449-1557
Mailing Address - Fax:559-449-1557
Practice Address - Street 1:7413 N CEDAR AVE STE 102
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3833
Practice Address - Country:US
Practice Address - Phone:559-449-1557
Practice Address - Fax:559-449-1557
Is Sole Proprietor?:No
Enumeration Date:2012-10-23
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12866225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics