Provider Demographics
NPI:1568014132
Name:MARIN, JOSEPHINE ZORAIDA (MFTC0013924)
Entity Type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:ZORAIDA
Last Name:MARIN
Suffix:
Gender:F
Credentials:MFTC0013924
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4545 WHEATON DR UNIT D280
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-7570
Mailing Address - Country:US
Mailing Address - Phone:405-464-8164
Mailing Address - Fax:
Practice Address - Street 1:8400 E CRESCENT PKWY STE 603
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2831
Practice Address - Country:US
Practice Address - Phone:720-370-1800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-12
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty