Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 5843 | LA |
NPI | 1003573452 |
---|---|
Provider Name | Dr. Christy Montgomery |
First Address | Covington, LA 70433-7474 |
Second Address | Covington, LA 70433-7474 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/11/2021 |
Last Update Date | 23/11/2021 |