Most Relevant Information
Provider Data
| NPI Number: | 1003591751 |
| Provider Name: | JARED THAYER MONTAGUE ALC, NCC |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: | ALC04482 |
Most Important Dates
| Enumeration Date: | 06/20/2023 |
| Last Updated: | 06/20/2023 |
Provider Practice Location
1117 22ND ST S STE 208
BIRMINGHAM
AL
352052813
Practice Location Phone/Fax
| Phone: | 2053196222 |
| Fax: |
Provider Mailing Location
2000 2ND AVE S APT 328
BIRMINGHAM
AL
352332075
Provider Mailing Phone/Fax
| Phone: | 4234403836 |
| Fax: |