Individual
KIVA MONTGOMERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.S.W.
Contact information
Practice address
3810 WINCHESTER RD, MEMPHIS, TN 38118-6045
(901) 369-1420
(901) 369-1433
Mailing address
937 BARBARA DR, MEMPHIS, TN 38108-3220
(901) 323-3049
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/18/2012
Last updated
01/18/2012
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