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Individual
MR. ERIC MARTIN MONTGOMERY SR.
Active
Individual
MR. ERIC MARTIN MONTGOMERY SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SUDCC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
CA
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101YA0400X
—
CA
Enumeration date
01/23/2012
Last updated
11/30/2021
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