Provider Demographics
NPI:1720890270
Name:MONTALVO, AIREEN ZOE
Entity type:Individual
Prefix:MRS
First Name:AIREEN
Middle Name:ZOE
Last Name:MONTALVO
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:MANSIONES DEL CARIBE 177
Mailing Address - Street 2:CALLE AQUAMARINA
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791-5218
Mailing Address - Country:US
Mailing Address - Phone:787-362-2588
Mailing Address - Fax:
Practice Address - Street 1:VILLA UNIVERSITARIA
Practice Address - Street 2:CALLE 26 BA-4
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791
Practice Address - Country:US
Practice Address - Phone:787-852-9331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-22
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8205103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling