Individual
CLINT A MONTGOMERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6432 SAINT JOSEPHS AVE NW, ALBUQUERQUE, NM 87120-3709
(860) 307-4212
Mailing address
1321 E POPLAR ST, DEMING, NM 88030-4807
(575) 546-5951
(575) 546-5994
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
242567
NM
Other
Enumeration date
10/28/2021
Last updated
10/28/2021
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