Healthcare Provider Details

I. General information

NPI: 1730847609
Provider Name (Legal Business Name): HAYLEE MARIE MONTOYA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2021
Last Update Date: 02/12/2026
Certification Date: 02/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3655 CARLISLE BLVD NE
ALBUQUERQUE NM
87110-1644
US

IV. Provider business mailing address

3655 CARLISLE BLVD NE
ALBUQUERQUE NM
87110-1644
US

V. Phone/Fax

Practice location:
  • Phone: 866-425-1912
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWB-2025-1171
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: