Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist |
NPI | 1093325003 |
---|---|
Provider Name | Megan Martinez |
First Address | Golden, CO 80401-5343 |
Second Address | Denver, CO 80222-4350 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2020 |
Last Update Date | 04/08/2020 |