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General NPI Number Information
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NPI Number | 1174408736
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Entity Type | Individual
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Provider Name | ABIGAIL MARTIN
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Gender | Female
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Dates
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Enumeration Date | 08/11/2025
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | 9362 GRAND CORDERA PKWY
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City | COLORADO SPRINGS
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State | CO
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Zip | 80924-7009
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Country | US
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Telephone | 719-345-0429
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Fax |
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Provider Business Mailing Address
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Address Line | 5031 AMAZONITE DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80938-8608
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Country | US
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Telephone | 406-546-8347
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | MSCSW.00000039
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License Number State | CO
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