Individual
MRS. JENNIFER MARY MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
6815 W CACTUS RD, PEORIA, AZ 85381-5313
(623) 937-5090
(623) 937-5349
Mailing address
6815 W. CACTUS RD., PEORIA, AZ 85381
(623) 937-5090
(623) 937-5349
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-11795
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LCSW-11795
—
AZ
Enumeration date
05/30/2007
Last updated
07/09/2007
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