Individual
MS. CARMENLITA LACKLAND MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 N VANDEVENTER AVE, SAINT LOUIS, MO 63113-3459
(314) 534-6015
Mailing address
1430 OLIVE ST STE 400, SAINT LOUIS, MO 63103-2303
(314) 206-3700
Taxonomy
Speciality
Code
Description
License number
State
103TF0200X
Forensic Psychologist
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
08/18/2022
Last updated
09/06/2022
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