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General NPI Number Information
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NPI Number | 1609753839
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Entity Type | Individual
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Provider Name | DARYEN MICHELLE MONTANA
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Gender | Female
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Dates
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Enumeration Date | 08/19/2025
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Last Update Date | 08/19/2025
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Provider Practice Location Address
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Address Line | 12617 S MCLOUD RD
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City | MCLOUD
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State | OK
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Zip | 74851-8509
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Country | US
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Telephone | 405-471-4755
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Fax |
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Provider Business Mailing Address
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Address Line | 15601 S ROCK CREEK RD
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City | SHAWNEE
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State | OK
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Zip | 74801-9786
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Country | US
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Telephone | 405-584-9262
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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