Provider Demographics
NPI:1982201117
Name:MONTGOMERY, SARAH MARIE (MA)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:MARIE
Last Name:MONTGOMERY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 EASTBROOK RD STE 104
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-2088
Mailing Address - Country:US
Mailing Address - Phone:781-329-9365
Mailing Address - Fax:781-302-4635
Practice Address - Street 1:20 EASTBROOK RD STE 104
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-2088
Practice Address - Country:US
Practice Address - Phone:813-299-3657
Practice Address - Fax:781-302-4635
Is Sole Proprietor?:No
Enumeration Date:2020-10-01
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health