Individual
AMANDA GRACE MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDCA
Contact information
Practice address
515 MARTIN DR, XENIA, OH 45385-1615
(937) 562-2400
(937) 562-2450
Mailing address
580 NEWPORT RD APT 24, XENIA, OH 45385-5237
(937) 603-6137
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
06/22/2022
Last updated
06/22/2022
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