| NPI | 1659889087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILY GROSSMAN Manager 406-518-1267 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MT BBH-LCPC-LIC-7698) |
| Enumeration Date | 2018-01-19 |
| Last Update Date | 2018-03-18 |