Provider Demographics
NPI:1831840354
Name:MONTES GARCIA, KIARA M
Entity type:Individual
Prefix:
First Name:KIARA
Middle Name:M
Last Name:MONTES GARCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 CALLE 4
Mailing Address - Street 2:URB. EMILIO CALIMANO
Mailing Address - City:MAUNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00707
Mailing Address - Country:US
Mailing Address - Phone:787-388-2021
Mailing Address - Fax:
Practice Address - Street 1:113 CALLE 4 URB. EMILIO CALIMANO
Practice Address - Street 2:URB. EMILIO CALIMANO
Practice Address - City:MAUNABO
Practice Address - State:PR
Practice Address - Zip Code:00707
Practice Address - Country:US
Practice Address - Phone:787-388-2021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-17
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6842103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR6101851Medicaid