Individual
JACLYN GROGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2339 CLASSIC CT, MISSOULA, MT 59801-1354
(406) 370-7211
Mailing address
2339 CLASSIC CT, MISSOULA, MT 59801-1354
(406) 370-7211
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
BBH-LCSW-LIC-25464
MT
Other
Enumeration date
09/12/2019
Last updated
09/13/2019
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