Provider Demographics
NPI:1326592585
Name:ISLAS-MONTANTES, VALERIA
Entity Type:Individual
Prefix:MRS
First Name:VALERIA
Middle Name:
Last Name:ISLAS-MONTANTES
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 1:4653 W PITCH PINE LN
Mailing Address - Street 2:3D
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-4993
Mailing Address - Country:US
Mailing Address - Phone:734-272-8362
Mailing Address - Fax:
Practice Address - Street 1:4653 W PITCH PINE LN
Practice Address - Street 2:3D
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-4993
Practice Address - Country:US
Practice Address - Phone:734-272-8362
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-04
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other