Provider Demographics
NPI:1679309025
Name:MONTES, GABRIELLA ELISE
Entity type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:ELISE
Last Name:MONTES
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 1:669 SANTREE CIR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89110-3938
Mailing Address - Country:US
Mailing Address - Phone:702-927-3163
Mailing Address - Fax:
Practice Address - Street 1:1834 PALLID SWIFT CT
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89084-2071
Practice Address - Country:US
Practice Address - Phone:702-300-9362
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician