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Individual

JOSE E MONTOYA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSWA

Contact information

Practice address
2740 PROSPERITY AVE STE 200, FAIRFAX, VA 22031-4354
(703) 321-2600
(703) 321-2603
Mailing address
6615 COMET CIR APT 103, SPRINGFIELD, VA 22150-4555
(336) 944-2554

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904010652
VA
1041C0700X
Clinical Social Worker
P010798
NC

Other

Enumeration date
08/28/2016
Last updated
02/11/2023
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