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Individual

DR. IDALIA MONTANEZ-MIRANDA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
2205 W LINCOLN AVE, YAKIMA, WA 98902-2437
(509) 469-6305
(509) 575-3398
Mailing address
2205 W LINCOLN AVE, YAKIMA, WA 98902-2437
(509) 469-6305
(509) 575-3398

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
IMH9410
FL
103T00000X
Psychologist
Primary
PY60898484
WA
103TC0700X
Clinical Psychologist
1342
NM
103TC0700X
Clinical Psychologist
2192
PR
103TC0700X
Clinical Psychologist
PY60898484
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PY60898484
DEPARTMENT OF HEALTH
WA
Enumeration date
08/04/2011
Last updated
11/29/2023
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