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General NPI Number Information
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NPI Number | 1801223722
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Entity Type | Individual
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Provider Name | KIMBERLEY MONTGOMERY M.A.,LPC-S
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Gender | Female
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Dates
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Enumeration Date | 10/09/2013
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Last Update Date | 01/10/2020
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Provider Practice Location Address
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Address Line | 106 S BRYAN BELT LINE RD
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City | MESQUITE
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State | TX
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Zip | 75149-4350
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Country | US
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Telephone | 972-882-6106
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Fax |
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Provider Business Mailing Address
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Address Line | 3517 DUBLIN TRL
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City | MESQUITE
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State | TX
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Zip | 75149-6753
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Country | US
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Telephone | 469-426-7735
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 68604
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License Number State | TX
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