Healthcare Provider Details

I. General information

NPI: 1104747286
Provider Name (Legal Business Name): GABRIELLA MONTERO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

293 CENTENNIAL DR RM 128
GRAND FORKS ND
58202-6066
US

IV. Provider business mailing address

1056 ALMA ST
RAPID CITY SD
57701-7920
US

V. Phone/Fax

Practice location:
  • Phone: 701-777-3745
  • Fax:
Mailing address:
  • Phone: 605-381-0898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: