| NPI | 1205115763 |
|---|---|
| Doing Business As | MARTIN PICKETT |
| Entity Type | Organization |
| Authorized Contact | STEVEN MARTIN PICKETT Owner 1843-270-7022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: FL PT25967) |
| 225XP0200X Occupational Therapist, Pediatrics (Licence: FL OT11414) | |
| 225XP0200X Occupational Therapist, Pediatrics (Licence: FL OT12006) | |
| 235Z00000X Speech-Language Pathologist, (Licence: FL SA7026) | |
| Enumeration Date | 2011-08-15 |
| Last Update Date | 2012-03-22 |