Healthcare Provider Details

I. General information

NPI: 1891672887
Provider Name (Legal Business Name): ANGELICA MONTOYA LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2025
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 902
SPRINGER NM
87747-0902
US

IV. Provider business mailing address

PO BOX 902
SPRINGER NM
87747-0902
US

V. Phone/Fax

Practice location:
  • Phone: 575-643-5676
  • Fax:
Mailing address:
  • Phone: 575-643-5676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberM-11865
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: