| NPI | 1902311269 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTINA K HAGEN Lcsw 406-926-1231 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MT BBH-LCSW-LIC-18186) |
| Enumeration Date | 2017-12-08 |
| Last Update Date | 2017-12-08 |