| Kimberly Montgomery Phd Hspp Llc | |
|
6296 Rucker Rd Ste A Indianapolis IN 46220-4852 | |
| (317) 580-4007 | |
| (833) 244-0469 |
| Full Name | Kimberly Montgomery Phd Hspp Llc |
|---|---|
| Speciality | Psychologist |
| Location | 6296 Rucker Rd Ste A, Indianapolis, Indiana |
| Authorized Official Name and Position | Kimberly G Montgomery (OWNER) |
| Authorized Official Contact | 3175804007 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kimberly Montgomery Phd Hspp Llc 6296 Rucker Rd Ste A Indianapolis IN 46220-4852 Ph: (317) 580-4007 | Kimberly Montgomery Phd Hspp Llc 6296 Rucker Rd Ste A Indianapolis IN 46220-4852 Ph: (317) 580-4007 |
| NPI Number | 1609530120 |
|---|---|
| Provider Enumeration Date | 10/30/2021 |
| Last Update Date | 10/30/2021 |
| Certification Date | 10/30/2021 |
| Medicare PECOS PAC ID | 8022408822 |
|---|---|
| Medicare Enrollment ID | O20211210000431 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609530120 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Kimberly G Montgomery |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1821170861 PECOS PAC ID: 4688738818 Enrollment ID: I20090203000015 |
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