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General NPI Number Information
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NPI Number | 1447408091
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Entity Type | Organization
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Legal Business Name | MARTEN PSYCHOTHERAPY ASSOCIATES, P.C.
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Dates
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Enumeration Date | 09/08/2008
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Last Update Date | 09/08/2008
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Provider Practice Location Address
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Address Line | 4465 NORTHPARK DR SUITE 300
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City | COLORADO SPRINGS
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State | CO
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Zip | 80907-4225
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Country | US
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Telephone | 719-471-3125
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Fax | 719-488-1733
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Provider Business Mailing Address
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Address Line | 4465 NORTHPARK DR SUITE 300
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City | COLORADO SPRINGS
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State | CO
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Zip | 80907-4225
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Country | US
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Telephone | 719-471-3125
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Fax | 719-488-1733
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRAD A MARTEN
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Credential | PSY.D.
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Telephone | 719-471-3125
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1395
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License Number State | CO
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