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1497464168
JAYDEE LYNN WEATHERWAX
MISSOULA, MT
NPI
1497464168
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MT BBH-ACLC-LIC-58873)
Enumeration Date
2022-11-21
Last Update Date
2022-12-13
Business Address
JAYDEE LYNN WEATHERWAX
1515 S RUSSELL ST
MISSOULA, MT 59801-3629
Phone number: 406-829-9515
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Mailing Address
JAYDEE LYNN WEATHERWAX
2100 STEPHENS AVE STE 105
MISSOULA, MT 59801-6607
Phone number: 406-829-9515
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