Individual
MS. BERNIE MONTANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSAA
Contact information
Practice address
216 W MALONEY AVE, GALLUP, NM 87301-5214
(505) 870-1483
Mailing address
216 W MALONEY AVE, GALLUP, NM 87301-5214
(505) 870-1483
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0188211
NM
Other
Enumeration date
06/21/2017
Last updated
07/21/2022
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