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Behavioral Health & Social Service Providers Counselor Mental Health

Provider NPI: 1346631355

Provider Information:
Gender: F
Not Sole Proprietor

Practice Location:
6 13TH AVE E  POLSON, MT 59860-5315 US
Tel: 815-451-9393  Fax: 406-883-8448

Business Mailing Address:
30989 ASPEN LN  POLSON, MT 59860-7554 US
Tel: 815-451-9393  Fax: 406-883-8448

NPI Information:
NPI: 1346631355
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Y101YM0800XBehavioral Health & Social Service Providers
Mental Health

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 101YM0800X





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