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Individual

DELORES DEE MONTGOMERY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
625 NW 13TH ST, OKLAHOMA CITY, OK 73103-2239
(405) 601-2307
(405) 601-3317
Mailing address
625 NW 13TH ST, OKLAHOMA CITY, OK 73103-2239
(405) 601-2307
(405) 601-3317

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200077440A
OK
Enumeration date
12/02/2010
Last updated
12/02/2010
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