Provider Demographics
NPI:1306091822
Name:MARTIN, MARGARET R (BS, COTA/L)
Entity type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:R
Last Name:MARTIN
Suffix:
Gender:F
Credentials:BS, COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2211 RIDGEWOOD DR NW
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:MN
Mailing Address - Zip Code:56308-4900
Mailing Address - Country:US
Mailing Address - Phone:605-695-4243
Mailing Address - Fax:
Practice Address - Street 1:2211 RIDGEWOOD DR NW
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:MN
Practice Address - Zip Code:56308-4900
Practice Address - Country:US
Practice Address - Phone:605-695-4243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-25
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN202020224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant