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NPI Code Detail

MEDICARE: MS. CHERI MONTGOMERY MSC

MEDICARE: MS. CHERI MONTGOMERY MSC
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
1106H00000XMarriage & Family TherapistMI0655NV

General Provider Information

NPI Number : 1134580202
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CHERI MONTGOMERY MSC
Provider Business Mailing Address
First Line : 4250 E BONANZA RD STE 17
Second Line :
City : LAS VEGAS
State : NV
Zip : 89110-6105
Country : US
Telephone Number : 702-280-7829
Fax Number :
Provider Business Practice Location Address
First Line : 4250 E BONANZA RD STE 17
Second Line :
City : LAS VEGAS
State : NV
Zip : 89110-6105
Country : US
Telephone Number : 702-280-7829
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2016
Last Update Date : 06/12/2020

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Directions to “ MS. CHERI MONTGOMERY MSC” Practice Location

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