Provider Demographics
NPI:1467698514
Name:MUNOZ, MARTIN KIRK (EDD)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:KIRK
Last Name:MUNOZ
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5244 SAGEBRUSH ST
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:CO
Mailing Address - Zip Code:80601-4645
Mailing Address - Country:US
Mailing Address - Phone:720-223-8144
Mailing Address - Fax:
Practice Address - Street 1:5244 SAGEBRUSH ST
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:CO
Practice Address - Zip Code:80601-4645
Practice Address - Country:US
Practice Address - Phone:720-223-8144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-19
Last Update Date:2008-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18626101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional