MEDICARE: MRS. MARY SUSAN KNOWLES MONTGOMERY M.ED., CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SA3436	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376626390
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARY SUSAN KNOWLES MONTGOMERY M.ED., CCC-SLP

Provider Business Mailing Address
First Line	:	1018 HAGLER DR
Second Line	:
City	:	NEPTUNE BEACH
State	:	FL
Zip	:	32266-3756
Country	:	US
Telephone Number	:	904-249-0685
Fax Number	:

Provider Business Practice Location Address
First Line	:	1018 HAGLER DR
Second Line	:
City	:	NEPTUNE BEACH
State	:	FL
Zip	:	32266-3756
Country	:	US
Telephone Number	:	904-249-0685
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	10/06/2011

Similar Medicare Providers

1043723810 — WORDS MATTER
Practice Location Address:

1018 HAGLER DR
NEPTUNE BEACH, FL
32266-3756

Practice Phone: 904-463-3152
Practice Fax: 904-249-0685

1891860698 — MD MEDICAL SUPPLIES INC.
Practice Location Address:

3756 CLIPPER BAY DR
VIRGINIA BEACH, VA
23455-2944

Practice Phone: 757-464-1700
Practice Fax: 757-961-0824

1275821621 — JESSICA SADA M.A. CCC-SLP
Practice Location Address:

1210 18TH AVE N
JACKSONVILLE BEACH, FL
32250-3756

Practice Phone: 570-956-5817
Practice Fax:

1770919664 — GRACE HARDY ITDS
Practice Location Address:

1210 18TH AVE N
JACKSONVILLE BEACH, FL
32250-3756

Practice Phone: 904-861-4927
Practice Fax:

1114331071 — THRIVE ABA CONSULTING LLC
Practice Location Address:

120 BOWERY ST , #308
VIRGINIA BEACH, VA
23462-3756

Practice Phone: 843-714-4266
Practice Fax:

1972992014 — CASEY BUCENELL BCABA
Practice Location Address:

120 BOWERY ST , #308
VIRGINIA BEACH, VA
23462-3756

Practice Phone: 757-750-1580
Practice Fax: 757-962-8888

Directions to “ MRS. MARY SUSAN KNOWLES MONTGOMERY M.ED., CCC-SLP” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.