| NPI | 1174229223 |
|---|---|
| Doing Business As | GLACIER LAKES THERAPY |
| Entity Type | Organization |
| Authorized Contact | PATRICK J LINDSTROM Billing & Coding Specialist 161-296-3588 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2023-01-31 |
| Last Update Date | 2023-05-19 |