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Individual
TAKARA DASHELLE BOLTON-MONTGOMERY
Active
Individual
TAKARA DASHELLE BOLTON-MONTGOMERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
6401225470
MI
101YP2500X
Professional Counselor
Primary
6451015824
MI
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
02/15/2017
Last updated
08/12/2026
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