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1801300702
CRYSTAL MARIE WAVRICK
MISSOULA, MT
NPI
1801300702
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: MT BBH-LCSW-LIC-25772)
Enumeration Date
2017-11-30
Last Update Date
2017-11-30
Business Address
CRYSTAL MARIE WAVRICK
619 SW HIGGINS AVE STE E
MISSOULA, MT 59803-1430
Phone number: 406-728-9672
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Mailing Address
CRYSTAL MARIE WAVRICK
4998 SONOMA ST
MISSOULA, MT 59808-8694
Phone number: 406-544-3551
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