Doctor Name: | MRS. MICHELLE MARIE MONTOYA |
NPI Number: | 1508036286 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | LPC3876 |
Business Practice Address: | 190 W. Main St Kuna, ID - 83634 |
Business Phone Number: | 2089229001 |
Business Fax Number: | 2089223778 |
Mailing Address: | 2146 W Trestle Dr, MERIDIAN |
State: | ID |
Postal Code: | 836461592 |
Phone Number: | 2082881453 |
Fax Number: | 2089223778 |
NPI Enumeration Date: | 03/10/2008 |
NPI Last Update Date: | 03/10/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | LPC3876 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |