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General NPI Number Information
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NPI Number | 1407243199
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Entity Type | Organization
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Legal Business Name | ERICA A. MONTOYA
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Dates
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Enumeration Date | 04/20/2015
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Last Update Date | 04/20/2015
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Provider Practice Location Address
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Address Line | 1832 ZEARING AVE NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87104-2072
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Country | US
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Telephone | 505-918-9690
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Fax |
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Provider Business Mailing Address
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Address Line | 1832 ZEARING AVE NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87104-2072
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Country | US
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Telephone | 505-918-9690
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Fax |
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Authorized Official
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Title or Position | LMSW
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Name | ERICA A MONTOYA
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Credential | MSW, LMSW
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Telephone | 505-918-9690
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | M-08062
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License Number State | NM
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