Provider Demographics
NPI:1841619475
Name:MARTIN, CHELSEA LATORRE (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHELSEA
Middle Name:LATORRE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:CHELSEA
Other - Middle Name:ANN
Other - Last Name:LATORRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:3030 S COLLEGE AVE UNIT 207
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-2557
Mailing Address - Country:US
Mailing Address - Phone:970-399-9950
Mailing Address - Fax:970-825-1895
Practice Address - Street 1:3030 S COLLEGE AVE UNIT 207
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-2557
Practice Address - Country:US
Practice Address - Phone:970-399-9950
Practice Address - Fax:970-825-1895
Is Sole Proprietor?:No
Enumeration Date:2014-04-10
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810007643103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical