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General NPI Number Information
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NPI Number | 1700495405
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Entity Type | Individual
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Provider Name | ANTONIA PATRICE MONTOYA LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/28/2020
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 8831 4TH ST NW UNIT B
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City | LOS RANCHOS
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State | NM
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Zip | 87114-1407
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Country | US
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Telephone | 505-333-9336
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 27191
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City | ALBUQUERQUE
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State | NM
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Zip | 87125-7191
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Country | US
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Telephone | 505-333-9336
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SWB-2023-0144
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License Number State | NM
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