Organization
ELLEN PAIGE MONTGOMERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELLEN PAIGE MONTGOMERY LPC (OWNER)
(678) 413-3833
Entity
Organization
Contact information
Practice address
1807 OVER LAKE DR SE, SUITE C, CONYERS, GA 30013-1777
(678) 413-3833
(770) 385-1832
Mailing address
1807 OVER LAKE DR SE, SUITE C, CONYERS, GA 30013-1777
(678) 413-3833
(770) 385-1832
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4154
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200566262A
—
GA
Enumeration date
10/14/2009
Last updated
10/14/2009
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