Provider Demographics
NPI:1528046687
Name:MONTOYA, ISABELLE KATHRYN (CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:ISABELLE
Middle Name:KATHRYN
Last Name:MONTOYA
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 W APACHE ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87401-5511
Mailing Address - Country:US
Mailing Address - Phone:505-327-7777
Mailing Address - Fax:505-327-7779
Practice Address - Street 1:701 W APACHE ST
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-5511
Practice Address - Country:US
Practice Address - Phone:505-327-7777
Practice Address - Fax:505-327-7779
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1887235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist