Provider Demographics
NPI:1699109835
Name:MONTANO, MARIA DE LOS ANGELES (BA/BHT)
Entity type:Individual
Prefix:
First Name:MARIA DE LOS ANGELES
Middle Name:
Last Name:MONTANO
Suffix:
Gender:F
Credentials:BA/BHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 W NORTHERN AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-4918
Mailing Address - Country:US
Mailing Address - Phone:602-866-9378
Mailing Address - Fax:602-866-9378
Practice Address - Street 1:2301 W NORTHERN AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-4918
Practice Address - Country:US
Practice Address - Phone:602-866-9378
Practice Address - Fax:602-866-9378
Is Sole Proprietor?:No
Enumeration Date:2013-08-23
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator