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NPI Code Detail

MEDICARE: MRS. CHRISTINA MARIE MONTGOMERY-EVANS CDCA

MEDICARE: MRS. CHRISTINA MARIE MONTGOMERY-EVANS CDCA
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
1106S00000XBehavior Technician
2101YA0400XAddiction (Substance Use Disorder) CounselorCDCA.175434OH

General Provider Information

NPI Number : 1245887124
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CHRISTINA MARIE MONTGOMERY-EVANS CDCA
Provider Business Mailing Address
First Line : 437 SAMOHT RIDGE RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45238-5531
Country : US
Telephone Number : 716-327-6390
Fax Number :
Provider Business Practice Location Address
First Line : 5505 CHEVIOT RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45247-7003
Country : US
Telephone Number : 513-740-1001
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2019
Last Update Date : 12/19/2023

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Directions to “ MRS. CHRISTINA MARIE MONTGOMERY-EVANS CDCA” Practice Location

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