| NPI | 1942650601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THADDEUS J WIDMER Mental Health Therapist 406-531-8846 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MT 860) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MT 872) |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2016-06-14 |