Individual
KASEY MONTGOMERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1286 JUNGERMANN RD, STE G, SAINT PETERS, MO 63376-6967
(815) 440-4758
Mailing address
123 MILL SIDE DR, SAINT PETERS, MO 63376-7019
(815) 440-4758
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
2013034795
MO
Other
Enumeration date
12/13/2013
Last updated
12/13/2013
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