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General NPI Number Information
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NPI Number | 1689584658
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Entity Type | Individual
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Provider Name | MARTINA ITA
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Gender | Female
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Dates
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Enumeration Date | 09/10/2026
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Last Update Date | 09/10/2026
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Provider Practice Location Address
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Address Line | 8000 E PRENTICE AVE STE B2
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80111-2726
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Country | US
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Telephone | 970-946-8737
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Fax |
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Provider Business Mailing Address
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Address Line | 545 LINDENWOOD CT
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City | HIGHLANDS RANCH
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State | CO
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Zip | 80126-2711
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Country | US
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Telephone | 402-937-2316
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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 | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | 24523636
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | LSW.0009927315
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License Number State | CO
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