MEDICARE: DANAE MARTINEZ-ALEXANDER

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	7000	CO

General Provider Information

NPI Number	:	1316784689
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANAE MARTINEZ-ALEXANDER

Provider Business Mailing Address
First Line	:	3787 S RICHFIELD ST
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80013-3072
Country	:	US
Telephone Number	:	303-549-2945
Fax Number	:

Provider Business Practice Location Address
First Line	:	1178 MARIPOSA ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80204-3507
Country	:	US
Telephone Number	:	720-608-7423
Fax Number	:

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

Provider Enumeration Date	:	07/12/2024
Last Update Date	:	07/12/2024

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