# BRAIDED WATER THERAPY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205545431
- **Authorized official:** MRS. CLAIRE LAH (ADMINTISTRATOR)
- **Authorized official phone:** (360) 471-0628

## Contact information

- **Practice address:** 280 W KAGY BLVD STE D, 109, BOZEMAN, MT 59715-6056
- **Practice address phone:** (360) 471-0628
- **Mailing address:** 280 W KAGY BLVD STE D, BOZEMAN, MT 59715-6056
- **Mailing address phone:** (360) 471-0628

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 11/16/2022
- **Last updated:** 11/16/2022