Provider Demographics
NPI:1700080124
Name:MONTLE, JOLINE HATHAWAY (LPC LMT)
Entity Type:Individual
Prefix:MRS
First Name:JOLINE
Middle Name:HATHAWAY
Last Name:MONTLE
Suffix:
Gender:F
Credentials:LPC LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4290 COUNTY ROAD 203
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-3715
Mailing Address - Country:US
Mailing Address - Phone:970-259-9469
Mailing Address - Fax:
Practice Address - Street 1:4290 COUNTY ROAD 203
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-3715
Practice Address - Country:US
Practice Address - Phone:970-259-9469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC 1381174400000X
FLLMT #MA25257174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1381OtherLICENSED PROF COUNSELOR
FLMA25257OtherLICENSED MASSAGETHERAPIST