Individual
ASHLEY ANTIONETTE MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1409 KIRKMAN ST, LAKE CHARLES, LA 70601
(337) 419-3583
Mailing address
1409 KIRKMAN ST, LAKE CHARLES, LA 70601-5344
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
164W00000X
Licensed Practical Nurse
20122542
LA
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/22/2017
Last updated
06/25/2019
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