Individual
MISS DOMINGA CRYSTAL MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1600 EDORA CT STE B, FORT COLLINS, CO 80525-6016
(720) 209-6346
Mailing address
2500 ROCKY MOUNTAIN AVE, LOVELAND, CO 80538-9004
(970) 624-2500
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW.09924474
CO
Other
Enumeration date
03/28/2011
Last updated
01/05/2023
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