Organization
WORDS MATTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY SUSAN KNOWLES MONTGOMERY M.ED., CCC-SLP (SPEECH-LANGUAGE PATHOLOGIST)
(904) 463-3152
Entity
Organization
Contact information
Practice address
1018 HAGLER DR, NEPTUNE BEACH, FL 32266-3756
(904) 463-3152
(904) 249-0685
Mailing address
1018 HAGLER DR, NEPTUNE BEACH, FL 32266-3756
(904) 463-3152
(904) 249-0685
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
SA3436
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
888761600
—
FL
Enumeration date
11/14/2017
Last updated
06/16/2018
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