Provider Demographics
NPI:1043262397
Name:MONTOYA, ROSALIE (LCSW)
Entity Type:Individual
Prefix:
First Name:ROSALIE
Middle Name:
Last Name:MONTOYA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4538 W CRAIG RD
Mailing Address - Street 2:SUITE 290
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-2508
Mailing Address - Country:US
Mailing Address - Phone:702-253-0818
Mailing Address - Fax:702-253-9625
Practice Address - Street 1:4538 W CRAIG RD
Practice Address - Street 2:SUITE 290
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-2508
Practice Address - Country:US
Practice Address - Phone:702-253-0818
Practice Address - Fax:702-253-9625
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV00649C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical