Healthcare Provider Details

I. General information

NPI: 1538774187
Provider Name (Legal Business Name): DANIELLA MONTOYA-WARREN LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2020
Last Update Date: 08/30/2024
Certification Date: 08/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

343 MAIN ST NW
LOS LUNAS NM
87031-8712
US

IV. Provider business mailing address

343 MAIN ST NW
LOS LUNAS NM
87031-8712
US

V. Phone/Fax

Practice location:
  • Phone: 505-866-8338
  • Fax:
Mailing address:
  • Phone: 505-866-8338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: