| NPI | 1285064246 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LACEY DAWN CORNELISEN Therapist 406-939-1976 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ND 4558) |
| Enumeration Date | 2013-11-12 |
| Last Update Date | 2013-11-12 |