Provider Demographics
NPI:1700757051
Name:MONTONEZ, TYLER PATRICK
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:PATRICK
Last Name:MONTONEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1951 51ST ST NE # 1
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-2466
Mailing Address - Country:US
Mailing Address - Phone:319-214-0350
Mailing Address - Fax:
Practice Address - Street 1:1951 51ST ST NE # 1
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-2466
Practice Address - Country:US
Practice Address - Phone:319-214-0350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA125484101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health