Basic Information
| Provider Information | |||||||||
| NPI: | 1275976292 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KEY | ||||||||
| FirstName: | MONTOYIA | ||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 109 FRANKIE LN | ||||||||
| Address2: | |||||||||
| City: | WHITE HALL | ||||||||
| State: | AR | ||||||||
| PostalCode: | 716022685 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8702473588 | ||||||||
| FaxNumber: | 8702472072 | ||||||||
| Practice Location | |||||||||
| Address1: | 109 FRANKIE LN | ||||||||
| Address2: | |||||||||
| City: | WHITE HALL | ||||||||
| State: | AR | ||||||||
| PostalCode: | 716022685 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8702473588 | ||||||||
| FaxNumber: | 8702472072 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/09/2013 | ||||||||
| LastUpdateDate: | 03/10/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/10/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | P1911139 | AR | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.