Individual
MR. MICHAEL ANDREW MONTGOMERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
7877 S HIGHWAY 89 # 91, WELLSVILLE, UT 84339-9416
(385) 388-7930
Mailing address
7877 S HIGHWAY 89 # 91, WELLSVILLE, UT 84339-9416
(385) 388-7930
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7334775-3501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
260022408
RAILROAD MEDICARE
UT
05
—
876000308007
—
UT
Enumeration date
10/15/2007
Last updated
04/27/2022
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