Provider Demographics
NPI:1730440520
Name:MARTIN, MERRI FELECIA (LMBT)
Entity type:Individual
Prefix:MISS
First Name:MERRI
Middle Name:FELECIA
Last Name:MARTIN
Suffix:
Gender:F
Credentials:LMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 W CHESTNUT ST
Mailing Address - Street 2:APT 6
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-1754
Mailing Address - Country:US
Mailing Address - Phone:513-910-6076
Mailing Address - Fax:
Practice Address - Street 1:29 RAVENSCROFT DR
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-3649
Practice Address - Country:US
Practice Address - Phone:513-910-6076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11804225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist