Individual
KAYLA MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2200 E SUNSHINE ST, SPRINGFIELD, MO 65804-1924
(417) 881-2444
Mailing address
1200 S ERIKA AVE, SPRINGFIELD, MO 65802-7129
(417) 241-9892
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2018029442
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2018029442
PROVISIONAL LICENSE PROFESSIONAL COUNSELOR
MO
Enumeration date
10/03/2018
Last updated
10/03/2018
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