Provider Demographics
NPI:1871249912
Name:MARTIN, KENDRA
Entity Type:Individual
Prefix:MISS
First Name:KENDRA
Middle Name:
Last Name:MARTIN
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 1:7110 SIMMS ST UNIT 104
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80004-1487
Mailing Address - Country:US
Mailing Address - Phone:646-624-9875
Mailing Address - Fax:
Practice Address - Street 1:7110 SIMMS ST UNIT 104
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80004-1487
Practice Address - Country:US
Practice Address - Phone:303-376-1360
Practice Address - Fax:303-763-5495
Is Sole Proprietor?:No
Enumeration Date:2022-02-28
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical