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Individual

KIMBERLEY SUE MONTGOMERY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
322 N MAIN ST, KOKOMO, IN 46901-4622
(765) 453-8238
Mailing address
322 N MAIN ST, KOKOMO, IN 46901-4622

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
1041C0700X
Clinical Social Worker
Primary
254519
KY
1041C0700X
Clinical Social Worker
34007283A
IN

Other

Enumeration date
02/09/2007
Last updated
09/17/2020
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