MEDICARE: DAWN MARIE MARTINEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	LPC-2570	WY

General Provider Information

NPI Number	:	1205517570
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAWN MARIE MARTINEZ

Provider Business Mailing Address
First Line	:	2109 LEXINGTON AVE
Second Line	:
City	:	CASPER
State	:	WY
Zip	:	82609-2947
Country	:	US
Telephone Number	:	605-431-2412
Fax Number	:

Provider Business Practice Location Address
First Line	:	940 E 3RD ST STE 102
Second Line	:
City	:	CASPER
State	:	WY
Zip	:	82601-3200
Country	:	US
Telephone Number	:	307-462-4876
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2023
Last Update Date	:	06/01/2026

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Directions to “ DAWN MARIE MARTINEZ ” Practice Location

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