Individual
AUTUMN MARIE DILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
1 WOODCOCKS WAY, ST. IGNATIUS, MT 59865
(406) 745-3525
Mailing address
P.O. BOX 880, ST. IGNATIUS, MT 59865
(406) 745-3525
(406) 745-3529
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
32707
MT
101YA0400X
Addiction (Substance Use Disorder) Counselor
BBH-LAC-LIC-32707
MT
104100000X
Social Worker
Primary
LSW41996
ID
1041C0700X
Clinical Social Worker
LCSW-41996
ID
Other
Enumeration date
10/18/2018
Last updated
04/07/2022
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