Doctor Name: | PATRICIA DIANE FORDYCE-MONTANARI |
NPI Number: | 1366757304 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMHC |
License Number: | 0132941 |
Business Practice Address: | 11 County Road 2952 Aztec, NM - 874109770 |
Business Phone Number: | 5053332334 |
Business Fax Number: | |
Mailing Address: | Po Box 1362, AZTEC |
State: | NM |
Postal Code: | 874101362 |
Phone Number: | 5053332334 |
Fax Number: | |
NPI Enumeration Date: | 08/14/2010 |
NPI Last Update Date: | 08/14/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 0132941 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |