Individual
MR. TERRELL MONTAGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
96 WISTERIA RD, GOOSE CREEK, SC 29445-3495
(843) 797-7871
(843) 797-8638
Mailing address
96 WISTERIA RD, GOOSE CREEK, SC 29445-3495
(843) 797-7871
(843) 797-8638
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
571048948
—
SC
Enumeration date
10/17/2016
Last updated
10/17/2016
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