Provider Demographics
NPI:1437435559
Name:MARTINEZ, DENETTE CHRISTINE (MA)
Entity Type:Individual
Prefix:
First Name:DENETTE
Middle Name:CHRISTINE
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-2708
Mailing Address - Country:US
Mailing Address - Phone:303-377-2586
Mailing Address - Fax:
Practice Address - Street 1:1425 MONROE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-2708
Practice Address - Country:US
Practice Address - Phone:303-377-2586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-03
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO12194101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health