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Individual

MS. MYCCA S. MONTOYA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMFT

Contact information

Practice address
1335 GUSDORF ROAD, BUILDING E, TAOS, NM 87571
(575) 445-9761
(575) 445-2887
Mailing address
480 WAGON MOUND, HWY 120, ROY, NM 87743
(575) 373-5117

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
0176281
NM
106H00000X
Marriage & Family Therapist
Primary
0189751
NM

Other

Enumeration date
08/20/2009
Last updated
06/22/2017
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