Individual
JENNY L MONTAGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSCW MSW
Contact information
Practice address
185 S MOORMAN AVE, SIERRA VISTA, AZ 85635-2700
(520) 458-3932
(520) 458-3585
Mailing address
489 N ARROYO BLVD, NOGALES, AZ 85621-2644
(520) 287-4713
(520) 287-9794
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LSCW 1721
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
644775
AHCCCS
AZ
Enumeration date
12/14/2006
Last updated
07/08/2007
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