| NPI | 1700635661 |
|---|---|
| Former Name | ERICA NICOLE MONTGOMERY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ID 79045) |
| Enumeration Date | 2024-05-14 |
| Last Update Date | 2024-05-20 |