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1043290273
DIETRA MONTALVO
FORT BRAGG, NC
NPI
1043290273
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: NC C0004559)
Enumeration Date
2006-01-23
Last Update Date
2016-03-21
Business Address
-- DIETRA MONTALVO LCSW
MCXC DPC MHO
FORT BRAGG, NC 28310-7301
Phone number: 910-555-5555
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Mailing Address
-- DIETRA MONTALVO LCSW
MCXC DPC MHO
FORT BRAGG, NC 28310-7301
Phone number: 910-555-5555
Copy
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