Pamela C Martin, COTA
Individual provider Active NPI Occupational Therapy Assistant · Moriarty, NM
NPI 1114350246 · NPPES record last updated Aug 13, 2013
Key facts
- NPI
- 1114350246
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 3115 (NM)
- Practice address
- 200 Center Street
Moriarty, NM 87035-2000 - Phone
- (505) 832-4471
- Fax
- (505) 832-4472
- NPI assigned
- Aug 13, 2013
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3115 | NM | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 3115 | NM | Yes |
Addresses
Primary practice location
200 Center Street
Moriarty, NM 87035-2000
Mailing address
PO Box 2000
Moriarty, NM 87035-2000
Phone (505) 832-4471
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 139 | Medicaid | TX |
Other providers in Moriarty, NM
- Sarah Jill Lyon
- Angela Mabry
- Christina Magnuson
- Gregory J Maroney
- Carla Martin
- Melissa Jean Martinez
- Sharon McBride
- Mind-Body Therapeutics
- Mailin Miranda
- Brenda Montoya
All providers in Moriarty, NM · Occupational Therapy Assistant in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 13, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.