Individual
MS. KAREN JEANETTE MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPOC, LISAC
Contact information
Practice address
483 W. SEED FARM RD, SACATON, AZ 85147-0001
(602) 528-7142
Mailing address
PO BOX 38, SACATON, AZ 85147-0001
(602) 528-7142
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LISAC-1416
AZ
101YM0800X
Mental Health Counselor
Primary
LPC-2215
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
346214
—
AZ
Enumeration date
09/23/2009
Last updated
09/23/2009
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