Doctor Name: | CAROLYN MONTOYA |
NPI Number: | 1598099764 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 0088151 |
Business Practice Address: | 4 Archuleta Rd Ranchos De Taos, NM - 875579756 |
Business Phone Number: | 5757511223 |
Business Fax Number: | 5757512812 |
Mailing Address: | 4 Archuleta Rd, RANCHOS DE TAOS |
State: | NM |
Postal Code: | 875579756 |
Phone Number: | 5757511223 |
Fax Number: | 5757512812 |
NPI Enumeration Date: | 09/21/2009 |
NPI Last Update Date: | 09/21/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 0088151 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |