Provider Demographics
NPI:1780314799
Name:MARTINEZ, CELINA MERCEDES (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:CELINA
Middle Name:MERCEDES
Last Name:MARTINEZ
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 1:4402 N 31ST AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85017-4044
Mailing Address - Country:US
Mailing Address - Phone:623-238-8714
Mailing Address - Fax:
Practice Address - Street 1:10631 S 51ST ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-5225
Practice Address - Country:US
Practice Address - Phone:480-398-4280
Practice Address - Fax:480-398-4281
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant