Provider Demographics
NPI:1417656232
Name:MARTINEZ, MARIAH JASMINE
Entity Type:Individual
Prefix:MRS
First Name:MARIAH
Middle Name:JASMINE
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8151 SOUTHPARK LN UNIT 100
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-4502
Mailing Address - Country:US
Mailing Address - Phone:720-617-1581
Mailing Address - Fax:
Practice Address - Street 1:8151 SOUTHPARK LN UNIT 100
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-4502
Practice Address - Country:US
Practice Address - Phone:720-617-1581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician