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Individual

DR. MARYJANE L. MONTALTO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY. D.

Contact information

Practice address
18-20 EAST MARKET STREET, BOX 134, RHINEBECK, NY 12572-1606
(845) 876-1241
(845) 229-4038
Mailing address
99 MOUNTAIN VIEW RD, RHINEBECK, NY 12572-2808
(845) 876-1241
(845) 229-4038

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
015561-1
NY
103TB0200X
Cognitive & Behavioral Psychologist
015561-1
NY
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
015561-1
NY
103TF0200X
Forensic Psychologist
015561-1
NY
103TM1800X
Intellectual & Developmental Disabilities Psychologist
015561-1
NY
103TR0400X
Rehabilitation Psychologist
015561-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02784958
NY
01
11661034
CAQH
NY
Enumeration date
06/29/2006
Last updated
05/22/2009
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