Provider Demographics
NPI:1447974522
Name:MEYER, MONTANA (MA, TLMHC)
Entity type:Individual
Prefix:
First Name:MONTANA
Middle Name:
Last Name:MEYER
Suffix:
Gender:F
Credentials:MA, TLMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38150 253RD AVE
Mailing Address - Street 2:
Mailing Address - City:LA MOTTE
Mailing Address - State:IA
Mailing Address - Zip Code:52054-9605
Mailing Address - Country:US
Mailing Address - Phone:563-581-5063
Mailing Address - Fax:
Practice Address - Street 1:38150 253RD AVE
Practice Address - Street 2:
Practice Address - City:LA MOTTE
Practice Address - State:IA
Practice Address - Zip Code:52054-9605
Practice Address - Country:US
Practice Address - Phone:563-581-5063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA116521101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health