MRS. Jerry A Montgomery, MSW ACSW LCSW

NPI #1750456356 in La Porte, Indiana

Provider Information

NPI Number: 1750456356
Entity Type: Individual
Name: MRS. Jerry A Montgomery, MSW ACSW LCSW
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Social Worker - Clinical
Credential: MSW ACSW LCSW
Enumeration Date: Nov 21, 2006
Last Updated: Mar 18, 2008

Practice Location

Address: 304 DETROIT ST
Address 2: SUITE A
City: La Porte
State: Indiana
ZIP Code: 46350-2473
Phone: (219) 617-0526

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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