Individual
CHERYEL MONTGOMERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1303 BALSAM AVE, BATON ROUGE, LA 70807-2901
(225) 715-9744
Mailing address
1303 BALSAM AVE, BATON ROUGE, LA 70807-2901
(225) 715-9744
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TA0700X
Adult Development & Aging Psychologist
—
—
103TH0100X
Health Service Psychologist
—
—
174200000X
Meals Provider
—
—
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0066
DRIVER
LA
05
—
0066
—
LA
05
—
1234
—
LA
01
—
6600
DRIVER
LA
05
—
6600
—
LA
05
—
MEDA
—
LA
Enumeration date
04/01/2021
Last updated
06/22/2023
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