Individual
MALLORY MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, ATR-BC
Contact information
Practice address
2800 W GRAND BLVD, DETROIT, MI 48202-2610
(133) 556-8188
Mailing address
2800 W GRAND BLVD, DETROIT, MI 48202-2610
Taxonomy
Speciality
Code
Description
License number
State
221700000X
Art Therapist
Primary
17-250
MI
Other
Enumeration date
12/06/2016
Last updated
08/11/2021
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