| NPI | 1609530120 |
|---|---|
| Former Legal Business Name | KIMBERLY G MONTGOMERY |
| Entity Type | Organization |
| Authorized Contact | KIMBERLY G MONTGOMERY Owner 317-580-4007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Enumeration Date | 2021-10-30 |
| Last Update Date | 2021-10-30 |