Most Relevant Information
Provider Data
NPI Number: | 1003393596 |
Provider Name: | MYKAYLA MONTGOMERY |
Entity Type: | Individual |
Taxonomy Code: | 106S00000X |
Specialty: | Behavior Technician |
License Number: |
Most Important Dates
Enumeration Date: | 07/26/2018 |
Last Updated: | 07/26/2018 |
Provider Practice Location
1901 ROYAL OAKS DR STE 201
SACRAMENTO
CA
958154235
Practice Location Phone/Fax
Phone: | 9169231789 |
Fax: |
Provider Mailing Location
1901 ROYAL OAKS DR STE 201
SACRAMENTO
CA
958154235
Provider Mailing Phone/Fax
Phone: | |
Fax: |