| NPI | 1689219941 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRISTINA FOWLER Licensed Clinical Social Worker 406-603-0211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Enumeration Date | 2019-11-11 |
| Last Update Date | 2020-08-17 |