Provider Demographics
NPI:1447306402
Name:GODOY, MARTA YANNETH (MA)
Entity type:Individual
Prefix:
First Name:MARTA
Middle Name:YANNETH
Last Name:GODOY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4310 N 13TH AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-2822
Mailing Address - Country:US
Mailing Address - Phone:602-451-0486
Mailing Address - Fax:
Practice Address - Street 1:1010 E MCDOWELL RD
Practice Address - Street 2:SUITE 301
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2606
Practice Address - Country:US
Practice Address - Phone:602-955-9059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor