Individual
JENNIFER SUE MONTGOMERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CT
Contact information
Practice address
14572 US HIGHWAY 23 STE A, WAVERLY, OH 45690-9448
(740) 947-6727
Mailing address
19883 STATE ROUTE 772, WAVERLY, OH 45690-9299
(740) 222-1124
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/25/2018
Last updated
09/25/2018
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