Individual
ROSE THERESE MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3225 INDEPENDENCE RD, CANON CITY, CO 81212-9380
(719) 275-2351
Mailing address
3225 INDEPENDENCE RD, CANON CITY, CO 81212-9380
(719) 275-2351
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACC.0007006
CO
Other
Enumeration date
11/12/2014
Last updated
11/12/2014
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