Montague, Terrell

Montague, Terrell is an individual health care provider with primary practice located at 96 Wisteria Rd , Goose Creek SC 29445-3495. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Montague, Terrell can be contacted via phone (843) 797-7871.

Contact Information

Primary practice address
96 Wisteria Rd Goose Creek SC 29445-3495
Phone: (843) 797-7871
Fax: (843) 797-8638
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X

Profile Details

NPI number 1003367905
LBN Legal business name Montague, Terrell
Credentials Master of Arts (MA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2016
Last updated Oct 17th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003367905 NPPES
South Carolina MEDICAID 571048948

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