Individual
MRS. LYNETTE SUZANNE MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASAC
Contact information
Practice address
380 FREEVILLE RD, FREEVILLE, NY 13068-9684
(607) 844-6493
Mailing address
15 HALSTEAD RD, CORTLAND, NY 13045-3405
(607) 345-0255
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
29787
NY
Other
Enumeration date
11/02/2015
Last updated
11/02/2015
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