Provider Demographics
NPI:1982019030
Name:MONTOYA, JASMINE (LMSW)
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:MONTOYA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12011 W. LOWRY ROAD
Mailing Address - Street 2:
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74107-3737
Mailing Address - Country:US
Mailing Address - Phone:918-704-3920
Mailing Address - Fax:
Practice Address - Street 1:12011 W. LOWRY ROAD
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74107-3737
Practice Address - Country:US
Practice Address - Phone:918-704-3920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-27
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2612MO801X101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health