Doctor Name: | ALDA EMMA MONTALVO |
NPI Number: | 1306090790 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCDC |
License Number: | 10109 |
Business Practice Address: | 700 Flournoy Rd Alice, TX - 783324003 |
Business Phone Number: | 3616640145 |
Business Fax Number: | 3616642248 |
Mailing Address: | Po Box 1820, ALICE |
State: | TX |
Postal Code: | 783331820 |
Phone Number: | 3616640145 |
Fax Number: | 3616642248 |
NPI Enumeration Date: | 11/11/2008 |
NPI Last Update Date: | 11/11/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 10109 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |