Doctor Name: | MRS. KYRA L MONTAGU |
NPI Number: | 1013104330 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSW LICSW |
License Number: | 1025010 |
Business Practice Address: | 1105 Massachusetts Ave Suite 2d Cambridge, MA - 02138 |
Business Phone Number: | 6172779814 |
Business Fax Number: | 6172779814 |
Mailing Address: | 1105 Massachusetts Ave, Suite 2d CAMBRIDGE |
State: | MA |
Postal Code: | 02138 |
Phone Number: | 6172779814 |
Fax Number: | 6172779814 |
NPI Enumeration Date: | 10/01/2007 |
NPI Last Update Date: | 10/01/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 1025010 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |