Facts
- Status
- A
- Credential
- LCSW
- Type
- Individual
- Enumeration date
- 2014-03-10
- Last updated
- 2022-02-04
Specialties
Licenses
- License MT
- BBH-LCSW-LIC-7661
Location
- Practice location
- 1 EISENHOWER ST SW
- City
- RONAN MT
- Postal code
- 598643302
- Phone
- 406-240-0038
Medicare
- PECOS
- A PECOS enrollment row matches this NPI.
LEIE
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Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.