Individual
DR. ROBERT W MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
107 WEATHERSTONE DR, SUITE 530, WOODSTOCK, GA 30188
(770) 591-9552
(800) 218-8249
Mailing address
107 WEATHERSTONE DR STE 530, WOODSTOCK, GA 30188-7006
(770) 591-9552
(800) 218-8249
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-03-1376
—
103TC0700X
Clinical Psychologist
Primary
PSY001980
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000637777E
—
GA
05
—
000637777F
—
GA
05
—
003216493A
—
GA
Enumeration date
08/29/2006
Last updated
11/18/2021
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