Provider Demographics
NPI:1972855013
Name:ASERINSKY, MARTHA KAMMEL (PHD)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:KAMMEL
Last Name:ASERINSKY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:MARTHA
Other - Middle Name:KAMMEL
Other - Last Name:BLANC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:2761 RESNIK CIR W
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34683-7222
Mailing Address - Country:US
Mailing Address - Phone:727-734-0307
Mailing Address - Fax:
Practice Address - Street 1:2761 RESNIK CIR W
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34683-7222
Practice Address - Country:US
Practice Address - Phone:727-734-0307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-14
Last Update Date:2012-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY8638103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist