Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003426727 |
---|---|
Provider Name | Christella Montoya |
First Address | Santa Ana, CA 92705-7875 |
Second Address | Albuquerque, NM 87111-1896 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2020 |
Last Update Date | 06/08/2020 |