Individual
JOSE MONTALVO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
419 WHALLEY AVE, NEW HAVEN, CT 06511-3019
(203) 285-6475
(203) 748-2604
Mailing address
38 OLD RIDGEBURY RD, DANBURY, CT 06810-5128
(203) 792-4515
(203) 748-2604
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
000667
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008044401
—
CT
01
—
1174607253
MIDWESTERN CONNECTICUT COUNCIL ON ALCOHOLISM
CT
Enumeration date
11/13/2013
Last updated
11/13/2013
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