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Individual

ALISA MONTGOMERY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
108-19 ROCKAWAY BLVD., SOUTH OZONE, NY 11420
(718) 845-2620
Mailing address
108-19 ROCKAWAY BLVD., OZONE PARK, NY 11420
(718) 845-2620

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
NY

Other

Enumeration date
08/19/2020
Last updated
08/19/2020
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