Individual
MS. BEVERLY MONTGOMERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16100 VAN AKEN BLVD APT 405, SHAKER HEIGHTS, OH 44120-5305
(216) 233-2434
Mailing address
16100 VAN AKEN BLVD APT 405, SHAKER HEIGHTS, OH 44120-5305
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
374U00000X
Home Health Aide
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
78835066
—
OH
Enumeration date
10/31/2022
Last updated
10/31/2022
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