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1063297430
GRACE MALLIS MONTGOMERY
TAMPA, FL
NPI
1063297430
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
235Z00000X Speech-Language Pathologist
Enumeration Date
2023-08-25
Last Update Date
2023-08-25
Business Address
GRACE MALLIS MONTGOMERY
4707 W GANDY BLVD STE 3
TAMPA, FL 33611-3310
Phone number: 813-728-6601
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Mailing Address
GRACE MALLIS MONTGOMERY
12831 TIKAL WAY
TRINITY, FL 34655-7253
Phone number: 727-386-3896
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