Individual
DEIRDRE MARY MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
2525 S WADSWORTH BLVD STE 303, LAKEWOOD, CO 80227-3246
(720) 962-4555
(720) 962-4466
Mailing address
7313 S JACKSON ST, CENTENNIAL, CO 80122-2215
(720) 217-5136
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-16-23249
WA
Other
Enumeration date
07/17/2017
Last updated
07/17/2017
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