Individual
MARY ELLEN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MFT
Contact information
Practice address
1218 GRIEGOS RD NW, ALBUQUERQUE, NM 87107-3752
(505) 345-8471
(505) 342-5414
Mailing address
6625 COUNTRY ESTATES LN, COLORADO SPRINGS, CO 80908-3001
(505) 604-2512
(505) 342-5414
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106H00000X
Marriage & Family Therapist
Primary
MFT.0001249
CO
Other
Enumeration date
06/28/2010
Last updated
10/16/2017
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