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Individual

MR. SHAEN MCELRAVY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSW, LAC

Contact information

Practice address
1325 WYOMING ST, MISSOULA, MT 59801-1725
(406) 532-9810
Mailing address
T-9 FORT MISSOULA, MISSOULA, MT 59804-7202
(406) 532-8400

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
821
MT

Other

Enumeration date
08/29/2006
Last updated
07/08/2007
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