Individual
DEIDRE MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW-A
Contact information
Practice address
942 W 4TH ST, WINSTON SALEM, NC 27101-2582
(336) 355-8244
Mailing address
3326 ARLINGTON DR, WINSTON SALEM, NC 27103-1532
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
P019575
NC
Other
Enumeration date
08/14/2023
Last updated
08/14/2023
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