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1215759832
LANDON RAY HEAVYRUNNER
MISSOULA, MT
NPI
1215759832
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: MT BBH-LCSW-LIC-72934)
Enumeration Date
2024-10-25
Last Update Date
2024-10-25
Business Address
LANDON RAY HEAVYRUNNER MSW, LCSW
1511 S RUSSELL ST
MISSOULA, MT 59801-3629
Phone number: 406-829-9515
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Mailing Address
LANDON RAY HEAVYRUNNER MSW, LCSW
1309 S 2ND ST W APT 3
MISSOULA, MT 59801-2386
Phone number: 406-529-0913
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