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Ms. Antinique Chanel Montgomery
Mental Health Counselor in Oakland, California
NPI 1336489509

Antinique Chanel Montgomery is a Mental Health Counselor based in Oakland, CA and is specialized in Mental Health. Antinique Chanel Montgomery practices in Oakland, CA. The NPI Number for Antinique Chanel Montgomery is 1336489509 and holds a License No. (California).

The current practice location address for Antinique Chanel Montgomery is 280 17Th St, Oakland, CA and can be reached out via phone at 510-238-5020 and via fax at 510-352-9981.

Location: 280 17Th St, Oakland, CA, 94612-4124
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1336489509
Provider Name
Antinique Chanel Montgomery
Credential
Provider Entity Type
Individual
Gender
Female
Address
280 17Th St, Oakland, CA, 94612-4124
Phone Number
510-238-5020
Fax Number
510-352-9981
Provider Enumeration Date
02/25/2013
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1411033663 01 CA EMPLOYER ID NUMBER
institution
Provider Business Practice Location Address Details
Address
280 17Th St
City
Oakland
State
California
Zip
94612-4124
Phone Number
510-238-5020
Fax Number
510-352-9981
person
Provider Business Mailing Address Details
Address
280 17Th St
City
Oakland
State
California
Zip
94612-4124
Phone Number
510-238-5020
Fax Number
510-352-9981
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
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