Individual
MS. TAMELA JEAN MONTGOMERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
829 HALBERT ST, MALVERN, AR 72104-2607
(501) 332-4400
Mailing address
2607 CADDO STE 6, ARKADELPHIA, AR 71923
(870) 230-8217
(870) 230-8201
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
P1405050
AR
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1366630378
UNITED HEALTHCARE BCBS
AR
Enumeration date
10/04/2007
Last updated
06/16/2018
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