Healthcare Provider Details

I. General information

NPI: 1528196797
Provider Name (Legal Business Name): DURANDA COSETTE MONTANEZ PH.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DURANDA COSETTE ORELLANA

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 S TELSHOR BLVD STE Q102
LAS CRUCES NM
88011-4681
US

IV. Provider business mailing address

755 S TELSHOR BLVD STE Q102
LAS CRUCES NM
88011-4681
US

V. Phone/Fax

Practice location:
  • Phone: 575-888-4666
  • Fax: 888-473-9160
Mailing address:
  • Phone: 575-888-4666
  • Fax: 888-473-9160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0944
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY944
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: