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1366711418
KASEY JOSEPH NICHOLSON
MISSOULA, MT
NPI
1366711418
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MT 1340 LAC)
Enumeration Date
2011-12-19
Last Update Date
2011-12-19
Business Address
Mr. KASEY JOSEPH NICHOLSON M.S., LAC
830 W CENTRAL AVE
MISSOULA, MT 59801-7931
Phone number: 406-829-9515
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Mailing Address
Mr. KASEY JOSEPH NICHOLSON M.S., LAC
830 W CENTRAL AVE
MISSOULA, MT 59801-7931
Phone number: 406-829-9515
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