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General NPI Number Information
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NPI Number | 1083521157
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Entity Type | Individual
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Provider Name | NICOLE MONTGOMERY
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Gender | Female
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Dates
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Enumeration Date | 08/25/2026
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Last Update Date | 08/25/2026
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Provider Practice Location Address
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Address Line | 1728 S 23RD ST
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City | MILWAUKEE
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State | WI
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Zip | 53204-3009
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Country | US
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Telephone | 414-393-3195
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Fax |
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Provider Business Mailing Address
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Address Line | 2173 S 87TH ST
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City | WEST ALLIS
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State | WI
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Zip | 53227-1719
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State | NULL
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