Individual
JESSIE L ALLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
1601 TAMMANY ST, ANACONDA, MT 59711-1845
(406) 563-7365
(406) 494-1724
Mailing address
PO BOX 1017, ANACONDA, MT 59711-1017
(406) 496-6314
(406) 474-1724
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1124
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1124
STATE OF MONTANA LICENSE
MT
Enumeration date
07/25/2007
Last updated
07/25/2007
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