Individual
WHITLEY MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPCC
Contact information
Practice address
3395 PLYMOUTH ROAD, MINNETONKA, MN 55305
(952) 939-0396
(952) 548-8760
Mailing address
3395 PLYMOUTH RD, MINNETONKA, MN 55305-3765
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CC01916
MN
Other
Enumeration date
09/11/2018
Last updated
09/11/2018
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