Individual
MOLLY GRACE MONTGOMERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
300 HOSPITAL ST, MOULTON, AL 35650-1268
(256) 974-1146
Mailing address
2887 COUNTY ROAD 28, MOULTON, AL 35650-6021
(256) 612-4849
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5917
AL
Other
Enumeration date
02/28/2024
Last updated
02/28/2024
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