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Individual

MS. MARY LOUISE MONTGOMERY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
B.S.

Contact information

Practice address
2200 FORT ROOTS DR, NORTH LITTLE ROCK, AR 72114-1709
(105) 257-1000
Mailing address
9 CEDARIDGE DR, JACKSONVILLE, AR 72076-9295
(501) 834-1667

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Enumeration date
09/20/2006
Last updated
07/08/2007
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