Individual
LINDA RAY MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0701002899
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
238474
ANTHEM
VA
Enumeration date
07/10/2006
Last updated
05/02/2008
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