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Shacoya Montgomery
Developmental Disabilities Clinic/Center in Lakeland, Florida
NPI 1316416381

Shacoya Montgomery is a Developmental Disabilities Clinic/Center based in Lakeland, FL and is specialized in Developmental Disabilities. Shacoya Montgomery practices in Lakeland, FL. The NPI Number for Shacoya Montgomery is 1316416381 and holds a License No. (Florida).

The current practice location address for Shacoya Montgomery is 3909 Sandhill Crane Dr, Lakeland, FL and can be reached out via phone at 863-617-5840.

Location: 3909 Sandhill Crane Dr, Lakeland, FL, 33811-1862
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1316416381
Provider Name
Shacoya Montgomery
Credential
Provider Entity Type
Individual
Gender
Female
Address
3909 Sandhill Crane Dr, Lakeland, FL, 33811-1862
Phone Number
863-617-5840
Fax Number
Provider Enumeration Date
11/19/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
824729967 05 FL
institution
Provider Business Practice Location Address Details
Address
3909 Sandhill Crane Dr
City
Lakeland
State
Florida
Zip
33811-1862
Phone Number
863-617-5840
Fax Number
person
Provider Business Mailing Address Details
Address
3909 Sandhill Crane Dr
City
Lakeland
State
Florida
Zip
33811-1862
Phone Number
863-617-5840
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Developmental Disabilities
Taxonomy
261QD1600X
License No.
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Definition
An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.).
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