Provider Demographics
NPI:1558653428
Name:ORR, MARTA B
Entity Type:Individual
Prefix:
First Name:MARTA
Middle Name:B
Last Name:ORR
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 1:304 GENERAL HODGES ST NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87123-1018
Mailing Address - Country:US
Mailing Address - Phone:505-440-9338
Mailing Address - Fax:
Practice Address - Street 1:304 GENERAL HODGES ST NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87123-1018
Practice Address - Country:US
Practice Address - Phone:505-440-9338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-10
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst