CLARENCE MONTGOMERY

MILWAUKEE, WI
NPI1659751162
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI  17466-130)
Enumeration Date2015-06-01
Last Update Date2015-06-01
Business Address
-- CLARENCE MONTGOMERY
1111 S 6TH ST 1111 S.6TH ST.
MILWAUKEE, WI 53204-2301
Phone number: 414-649-0189
Mailing Address
-- CLARENCE MONTGOMERY
1111 S 6TH ST 1111 S.6TH ST.
MILWAUKEE, WI 53204-2301
Phone number: 414-649-0189
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