Provider Demographics
NPI:1114789096
Name:MONTES GONZALEZ, ARIANA (LAC)
Entity Type:Individual
Prefix:
First Name:ARIANA
Middle Name:
Last Name:MONTES GONZALEZ
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:281 W 24TH ST STE 123
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-8539
Mailing Address - Country:US
Mailing Address - Phone:928-247-6430
Mailing Address - Fax:
Practice Address - Street 1:281 W 24TH ST STE 123
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-8539
Practice Address - Country:US
Practice Address - Phone:928-247-6430
Practice Address - Fax:928-436-8669
Is Sole Proprietor?:No
Enumeration Date:2024-01-26
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-22597101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor