Provider Demographics
NPI:1083055032
Name:MARTINEZ, BETTY JEAN (RESIDENTIAL COUNSELO)
Entity Type:Individual
Prefix:MRS
First Name:BETTY
Middle Name:JEAN
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:RESIDENTIAL COUNSELO
Other - Prefix:
Other - First Name:BETTY
Other - Middle Name:JEAN
Other - Last Name:CARRASCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:322 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:LA SALLE
Mailing Address - State:CO
Mailing Address - Zip Code:80645-3082
Mailing Address - Country:US
Mailing Address - Phone:970-284-5285
Mailing Address - Fax:970-284-5258
Practice Address - Street 1:1512 MONACO PKWY
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-1641
Practice Address - Country:US
Practice Address - Phone:970-284-5258
Practice Address - Fax:970-284-5285
Is Sole Proprietor?:No
Enumeration Date:2013-07-07
Last Update Date:2013-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator