Individual
KATHERINE L GILLISPIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, BCBA
Contact information
Practice address
210 N HIGGINS AVE STE 337, MISSOULA, MT 59802-4443
(406) 529-9516
(888) 978-6176
Mailing address
PO BOX 5814, MISSOULA, MT 59806-5814
(406) 529-9516
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-12-10348
MT
1041C0700X
Clinical Social Worker
Primary
964
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
77039
—
MT
Enumeration date
04/06/2012
Last updated
01/03/2022
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