| Doctor Name: | JENNIFER MONTGOMERY |
| NPI Number: | 1033577630 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSW, LCSWA |
| License Number: | P010114 |
| Business Practice Address: | 4270 Heath Dairy Rd Randleman, NC - 273177489 |
| Business Phone Number: | 3364952700 |
| Business Fax Number: | |
| Mailing Address: | 8753 Camden Park Dr, RALEIGH |
| State: | NC |
| Postal Code: | 276136945 |
| Phone Number: | 9105840934 |
| Fax Number: | |
| NPI Enumeration Date: | 02/10/2016 |
| NPI Last Update Date: | 02/10/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | P010114 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |