Individual
AMY J MONTGOMERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
143 N MCCORMICK ST STE 103, PRESCOTT, AZ 86301-2725
(928) 300-2643
Mailing address
143 N MCCORMICK ST STE 103, PRESCOTT, AZ 86301-2725
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LAC-19003
AZ
Other
Enumeration date
05/28/2020
Last updated
05/28/2020
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