Individual
DONALD KEITH MONTGOMERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW, LCDC
Contact information
Practice address
8133 MESA DR STE 104, AUSTIN, TX 78759-8655
(628) 203-5667
Mailing address
PO BOX 202682, AUSTIN, TX 78720-2682
(512) 788-4452
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
60189
TX
Other
Enumeration date
09/04/2018
Last updated
09/04/2018
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