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Individual

INGO D MONTGOMERY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MS, BA, LICDC, LSW

Contact information

Practice address
835 N LOCUST ST, OTTAWA, OH 45875-1216
(419) 523-4300
(419) 523-6188
Mailing address
835 N LOCUST ST, OTTAWA, OH 45875-1216
(419) 523-4300
(419) 523-6188

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
82777
OH
1041C0700X
Clinical Social Worker
0027904
OH

Other

Enumeration date
07/08/2008
Last updated
07/08/2008
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