Provider Demographics
NPI:1639722192
Name:MONTANEZ, NATALIE MARIE (MA, ACMHC)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:MARIE
Last Name:MONTANEZ
Suffix:
Gender:F
Credentials:MA, ACMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8265 W 2700 S
Mailing Address - Street 2:
Mailing Address - City:MAGNA
Mailing Address - State:UT
Mailing Address - Zip Code:84044-1323
Mailing Address - Country:US
Mailing Address - Phone:786-354-4659
Mailing Address - Fax:
Practice Address - Street 1:8265 W 2700 S
Practice Address - Street 2:
Practice Address - City:MAGNA
Practice Address - State:UT
Practice Address - Zip Code:84044-1323
Practice Address - Country:US
Practice Address - Phone:786-354-4659
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-23
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT113134076009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health