Provider Demographics
NPI:1427485978
Name:MONTANEZ, HAIDZA DELGADO
Entity type:Individual
Prefix:MISS
First Name:HAIDZA
Middle Name:DELGADO
Last Name:MONTANEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:C1 CALLE K
Mailing Address - Street 2:URB. MENDEZ
Mailing Address - City:YABUCOA
Mailing Address - State:PR
Mailing Address - Zip Code:00767-3218
Mailing Address - Country:US
Mailing Address - Phone:787-567-1600
Mailing Address - Fax:
Practice Address - Street 1:C1 CALLE K
Practice Address - Street 2:URB. MEDEZ
Practice Address - City:YABUCOA
Practice Address - State:PR
Practice Address - Zip Code:00767-3218
Practice Address - Country:US
Practice Address - Phone:787-567-1600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-30
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3867103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool