Provider Demographics
NPI:1851327175
Name:PEARSE, MARTHA (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:
Last Name:PEARSE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:MARTHA
Other - Middle Name:
Other - Last Name:PEARSE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:2055 IVY ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80207-3906
Mailing Address - Country:US
Mailing Address - Phone:303-377-1188
Mailing Address - Fax:
Practice Address - Street 1:2055 IVY ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80207-3906
Practice Address - Country:US
Practice Address - Phone:303-377-1188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1000103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist