| Doctor Name: | MS. COLLEEN LESLEY MONTGOMERY |
| NPI Number: | 1073815221 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCPC |
| License Number: | LC3540 |
| Business Practice Address: | 103 Solomons Ridge Ct Millersville, MD - 211081268 |
| Business Phone Number: | 4103364950 |
| Business Fax Number: | 4107935569 |
| Mailing Address: | 103 Solomons Ridge Ct, MILLERSVILLE |
| State: | MD |
| Postal Code: | 211081268 |
| Phone Number: | 4103364950 |
| Fax Number: | 4107935569 |
| NPI Enumeration Date: | 11/21/2010 |
| NPI Last Update Date: | 11/21/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | LC3540 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |