Provider Demographics
NPI:1861694820
Name:PARKER, MARTHA LYNN (MSW, PHD)
Entity type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:LYNN
Last Name:PARKER
Suffix:
Gender:F
Credentials:MSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:748 S OGDEN ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-4422
Mailing Address - Country:US
Mailing Address - Phone:303-871-3676
Mailing Address - Fax:
Practice Address - Street 1:748 S OGDEN ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-4422
Practice Address - Country:US
Practice Address - Phone:303-871-3676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8764091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical