Individual
TAZIA WISDOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PCLC
Contact information
Practice address
1935 3RD AVE E, KALISPELL, MT 59901-5780
(504) 357-1773
Mailing address
404 3RD AVE E, KALISPELL, MT 59901-4907
(504) 357-1773
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
BBH-LCPC-LIC-87709
MT
101YM0800X
Mental Health Counselor
Primary
BBH-PCLC-LIC-50455
MT
Other
Enumeration date
03/04/2025
Last updated
04/01/2026
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