| NPI | 1598546103 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAORU POWELL Clinical Psychologist 406-219-5938 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent |
| Enumeration Date | 2023-10-10 |
| Last Update Date | 2023-11-07 |