Individual
MAXINE MONTOYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCDC
Contact information
Practice address
1219 BARRANCA DR, EL PASO, TX 79935-4601
(915) 779-5600
(915) 779-5605
Mailing address
1219 BARRANCA DR, EL PASO, TX 79935-4601
(915) 779-5600
(915) 779-5605
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
9640
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
152192402
—
TX
Enumeration date
07/09/2013
Last updated
07/09/2013
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