Healthcare Provider Details

I. General information

NPI: 1871713305
Provider Name (Legal Business Name): GABRIELLA HELAINE-WOLF MONTGOMERY MC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1230 S CHERRYBELL STRA
TUCSON AZ
85713-1907
US

IV. Provider business mailing address

839 W CONGRESS ST
TUCSON AZ
85745-2819
US

V. Phone/Fax

Practice location:
  • Phone: 520-670-3909
  • Fax: 520-309-2560
Mailing address:
  • Phone: 520-670-3909
  • Fax: 520-309-2560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLPC-12649
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: