| NPI | 1962824706 |
|---|---|
| Former Name | JENNIFER JEAN MONTGOMERY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 63059) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6801093215) |
| Enumeration Date | 2014-01-14 |
| Last Update Date | 2016-12-12 |