| NPI | 1942699350 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELEANOR P. LAVIN Member 406-234-7890 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MT 12752) |
| Enumeration Date | 2015-01-22 |
| Last Update Date | 2015-02-01 |