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General NPI Number Information
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NPI Number | 1932482296
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Entity Type | Individual
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Provider Name | REESHA FAYE JEANETTE MONTGOMERY LMFT
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Gender | Female
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Dates
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Enumeration Date | 09/23/2011
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | PO BOX 748465
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City | ATLANTA
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State | GA
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Zip | 30374-8465
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Country | US
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Telephone | 855-284-7483
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Fax |
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Provider Business Mailing Address
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Address Line | 5707 N 22ND ST
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City | TAMPA
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State | FL
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Zip | 33610-4350
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Country | US
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Telephone | 813-239-8069
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Fax | 813-231-7324
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MT3417
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MT3417
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License Number State | FL
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