Provider Demographics
NPI:1871837112
Name:MARTIN, ELIZABETH MILER (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:MILER
Last Name:MARTIN
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 1:14385 SUNDOWN DR
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96003-9491
Mailing Address - Country:US
Mailing Address - Phone:530-515-6690
Mailing Address - Fax:
Practice Address - Street 1:14385 SUNDOWN DR
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96003-9491
Practice Address - Country:US
Practice Address - Phone:530-515-6690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-26
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8038225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation