Provider Demographics
NPI:1154660942
Name:MONTGOMERY, SUSAN E (PCD(DONA))
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:E
Last Name:MONTGOMERY
Suffix:
Gender:F
Credentials:PCD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 YORKTOWN RD
Mailing Address - Street 2:
Mailing Address - City:COLLEGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-1735
Mailing Address - Country:US
Mailing Address - Phone:610-220-6724
Mailing Address - Fax:
Practice Address - Street 1:103 YORKTOWN RD
Practice Address - Street 2:
Practice Address - City:COLLEGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19426-1735
Practice Address - Country:US
Practice Address - Phone:610-220-6724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-13
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula