Earline Cynthel Montgomery
Counselor, Mental Health in Mattoon, IL. Individual provider (NPI-1).
NPI number1982108239
StatusActive
Last updated in NPPESMar 21, 2018
Details
- NPI
- 1982108239
- Entity type
- Individual (NPI-1)
- Name
- Earline Cynthel Montgomery
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 21, 2018
- Last updated
- Mar 21, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | – | Yes |
Other names
- Earline Bower (Former Name)
Practice location
750 Broadway Ave EMattoon, IL 61938-4610
Phone 217-238-5700
Mailing address
750 Broadway Ave EMattoon, IL 61938-4610
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