Provider Demographics
NPI:1528944543
Name:MARTENS, TAMERA (LAAC)
Entity type:Individual
Prefix:
First Name:TAMERA
Middle Name:
Last Name:MARTENS
Suffix:
Gender:F
Credentials:LAAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:549 S PASEO BOLSILLO
Mailing Address - Street 2:
Mailing Address - City:GREEN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85614-1941
Mailing Address - Country:US
Mailing Address - Phone:520-284-6582
Mailing Address - Fax:
Practice Address - Street 1:549 S PASEO BOLSILLO
Practice Address - Street 2:
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85614-1941
Practice Address - Country:US
Practice Address - Phone:520-284-6582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAAC-15587101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)