Individual
MARISSA JASMINE MONTOYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2603 CENTRAL AVE, DODGE CITY, KS 67801-6210
(620) 789-0111
(620) 471-2031
Mailing address
2603 CENTRAL AVE, DODGE CITY, KS 67801-6210
(620) 789-0111
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
KS
Other
Enumeration date
03/29/2023
Last updated
03/29/2023
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