Provider Demographics
NPI:1477399301
Name:MONTOYA, ERIKA MICHEL (COUNSELING INTERN)
Entity type:Individual
Prefix:MRS
First Name:ERIKA
Middle Name:MICHEL
Last Name:MONTOYA
Suffix:
Gender:F
Credentials:COUNSELING INTERN
Other - Prefix:MRS
Other - First Name:ERIKA
Other - Middle Name:M
Other - Last Name:MONTOYA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ERIKA MACIAS
Mailing Address - Street 1:3081 N BLUE SPRINGS AVE
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83646-8297
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2995 N COLE RD STE 225
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-5966
Practice Address - Country:US
Practice Address - Phone:208-614-0558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCOUI-10302101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor