Individual
BREANNA J. MONTOYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
384 SW UPPER TERRACE DR STE 202, BEND, OR 97702-3432
(541) 788-9642
(651) 647-1413
Mailing address
2111 NW BLACK PINES PL, BEND, OR 97703-1678
(541) 788-9642
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
106H00000X
Marriage & Family Therapist
Primary
T1340
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500661132
—
OR
Enumeration date
04/28/2008
Last updated
07/22/2019
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