Individual
CRYSTAL DAWN MONTGOMERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
615 N BROADVIEW ST STE 102, CAPE GIRARDEAU, MO 63701-4372
(573) 334-2889
Mailing address
114 DAVID DR, JACKSON, MO 63755-7780
(573) 579-2465
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2015034790
MO
Other
Enumeration date
12/30/2018
Last updated
12/30/2018
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