Provider Demographics
NPI:1548524895
Name:MELENDEZ MONTOYA, MARIA MARGARITA (MALPCLASAC)
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:MARGARITA
Last Name:MELENDEZ MONTOYA
Suffix:
Gender:F
Credentials:MALPCLASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5536 S DESERT REDBUD DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85757-7503
Mailing Address - Country:US
Mailing Address - Phone:520-309-5002
Mailing Address - Fax:
Practice Address - Street 1:620 N COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-4504
Practice Address - Country:US
Practice Address - Phone:520-309-5002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-02
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC13956101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional