Provider Demographics
NPI:1366814865
Name:MARTIN, BRITTANY KARYNNE RUSSELL (MS OTR/L)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:KARYNNE RUSSELL
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:KARYNNE
Other - Last Name:RUSSELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS OTR/L
Mailing Address - Street 1:1305 DARES BEACH RD
Mailing Address - Street 2:
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678-4208
Mailing Address - Country:US
Mailing Address - Phone:435-550-8373
Mailing Address - Fax:
Practice Address - Street 1:1305 DARES BEACH RD
Practice Address - Street 2:
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-4208
Practice Address - Country:US
Practice Address - Phone:443-550-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-22
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07804225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist