Provider Demographics
NPI:1801220355
Name:MONT, DENISE ILIANA (MA,CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:DENISE
Middle Name:ILIANA
Last Name:MONT
Suffix:
Gender:F
Credentials:MA,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 28
Mailing Address - Street 2:
Mailing Address - City:GARCIASVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78547-0028
Mailing Address - Country:US
Mailing Address - Phone:512-736-5997
Mailing Address - Fax:
Practice Address - Street 1:5346 E US HIGHWAY 83
Practice Address - Street 2:
Practice Address - City:RIO GRANDE CITY
Practice Address - State:TX
Practice Address - Zip Code:78582-9471
Practice Address - Country:US
Practice Address - Phone:956-735-4811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-01
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106874235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist