Provider Demographics
NPI:1689390585
Name:MONTGOMERY, EMILY LENORE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:LENORE
Last Name:MONTGOMERY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 MANCHESTER CT
Mailing Address - Street 2:
Mailing Address - City:YARMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04096-1548
Mailing Address - Country:US
Mailing Address - Phone:207-400-9849
Mailing Address - Fax:
Practice Address - Street 1:12 MANCHESTER CT
Practice Address - Street 2:
Practice Address - City:YARMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04096-1548
Practice Address - Country:US
Practice Address - Phone:207-400-9849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist