Provider Demographics
NPI:1083082440
Name:MONTANYE, TED III
Entity Type:Individual
Prefix:
First Name:TED
Middle Name:
Last Name:MONTANYE
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:THEODORE
Other - Middle Name:BRYAN
Other - Last Name:MONTANYE
Other - Suffix:III
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:11130 MARSHALL ST
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80020-3139
Mailing Address - Country:US
Mailing Address - Phone:720-324-0333
Mailing Address - Fax:
Practice Address - Street 1:11130 MARSHALL ST
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80020-3139
Practice Address - Country:US
Practice Address - Phone:720-324-0333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-02
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor