Organization
MONTGOMERY INDIVIDUAL AND FAMILY THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AYNGI MONTGOMERY LPC (OWNER)
(918) 852-9644
Entity
Organization
Contact information
Practice address
10306 N 138TH EAST AVE, OWASSO, OK 74055-4665
(918) 852-9644
Mailing address
PO BOX 700082, TULSA, OK 74170-0082
(918) 852-9644
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
4100
OK
Other
Enumeration date
10/25/2009
Last updated
10/25/2009
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