Provider Demographics
NPI:1477647907
Name:MONTANI, GRACIELA MARIS (LPC; LMFT)
Entity Type:Individual
Prefix:MS
First Name:GRACIELA
Middle Name:MARIS
Last Name:MONTANI
Suffix:
Gender:F
Credentials:LPC; LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 W. JEFFERSON BLVD.
Mailing Address - Street 2:SUITE 205
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-5091
Mailing Address - Country:US
Mailing Address - Phone:214-941-1650
Mailing Address - Fax:214-941-8008
Practice Address - Street 1:1005 W. JEFFERSON BLVD.
Practice Address - Street 2:SUITE 205
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-5091
Practice Address - Country:US
Practice Address - Phone:214-941-1650
Practice Address - Fax:214-941-8008
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3445101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health