| NPI | 1619465788 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA C WILSON Clinical Mental Health Counselor 406-360-8470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MT 4654) |
| Enumeration Date | 2018-04-24 |
| Last Update Date | 2018-06-16 |