Most Relevant Information
Provider Data
| NPI Number: | 1003367905 |
| Provider Name: | TERRELL MONTAGUE MA |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/17/2016 |
| Last Updated: | 10/17/2016 |
Provider Practice Location
96 WISTERIA RD
GOOSE CREEK
SC
294453495
Practice Location Phone/Fax
| Phone: | 8437977871 |
| Fax: | 8437978638 |
Provider Mailing Location
96 WISTERIA RD
GOOSE CREEK
SC
294453495
Provider Mailing Phone/Fax
| Phone: | 8437977871 |
| Fax: | 8437978638 |