| Doctor Name: | JOSEPH MONTGOMERY |
| NPI Number: | 1104155126 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MA LLPC |
| License Number: | 6401011520 |
| Business Practice Address: | 42669 Garfield Rd Clinton Twp, MI - 480385036 |
| Business Phone Number: | 5864125321 |
| Business Fax Number: | 5864125327 |
| Mailing Address: | 12850 Fountain Sq Ste 106, DAVISBURG |
| State: | MI |
| Postal Code: | 483502552 |
| Phone Number: | 5864125321 |
| Fax Number: | 5864125327 |
| NPI Enumeration Date: | 12/22/2009 |
| NPI Last Update Date: | 12/22/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 6401011520 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |