| NPI | 1265853667 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE DANIELLE RODRIGUEZ Clinical Social Worker 406-465-9738 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MT 647-LCSW) |
| Enumeration Date | 2014-01-02 |
| Last Update Date | 2014-01-02 |