Individual
ANNIE JESSICA MONTGOMERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5756 CLEARBROOK RD, EFFINGHAM, SC 29541-3116
(843) 373-1793
Mailing address
5756 CLEARBROOK RD, EFFINGHAM, SC 29541-3116
(843) 373-1793
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
SC
Other
Enumeration date
07/20/2020
Last updated
07/20/2020
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