Individual
JACQUELINE MONTGOMERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2648 RAVENALL AVE, ORLANDO, FL 32811-5544
(407) 272-1806
Mailing address
2648 RAVENALL AVE, ORLANDO, FL 32811-5544
(407) 272-1806
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
LPC0460030715
FL
175T00000X
Peer Specialist
—
FL
Other
Enumeration date
08/24/2016
Last updated
09/08/2025
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