Provider Demographics
NPI:1871706176
Name:RODEHEFFER, MARTHA ANN (PHD)
Entity type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:ANN
Last Name:RODEHEFFER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:29029 UPPER BEAR CREEK RD
Mailing Address - Street 2:SUITE 305
Mailing Address - City:EVERGREEN
Mailing Address - State:CO
Mailing Address - Zip Code:80439-7738
Mailing Address - Country:US
Mailing Address - Phone:303-670-1864
Mailing Address - Fax:303-674-1627
Practice Address - Street 1:29029 UPPER BEAR CREEK RD
Practice Address - Street 2:SUITE 305
Practice Address - City:EVERGREEN
Practice Address - State:CO
Practice Address - Zip Code:80439-7738
Practice Address - Country:US
Practice Address - Phone:303-670-1864
Practice Address - Fax:303-674-1627
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO524103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling