Individual
CHINNIU MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1704 W MANCHESTER AVE, LOS ANGELES, CA 90047-3063
(323) 759-6224
Mailing address
1538 E KAY ST, COMPTON, CA 90221-1752
(310) 766-0547
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/29/2008
Last updated
07/29/2008
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