Healthcare Provider Details

I. General information

NPI: 1548444151
Provider Name (Legal Business Name): HANNAH L MARTENS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2007
Last Update Date: 11/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 S ASH ST
YUMA CO
80759-1903
US

IV. Provider business mailing address

211 W MAIN ST
STERLING CO
80751-3168
US

V. Phone/Fax

Practice location:
  • Phone: 970-848-5412
  • Fax: 970-848-2414
Mailing address:
  • Phone: 970-522-4549
  • Fax: 970-522-6898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberMFT0000967
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: