Individual
CHRISTINA K NEWELL WYATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
302 1ST ST W STE 104, POLSON, MT 59860-2602
(406) 210-0035
(406) 635-8695
Mailing address
PO BOX 1382, POLSON, MT 59860-1382
(406) 210-0035
(406) 635-8695
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
BBH-LCSW-LIC-57488
MT
1041C0700X
Clinical Social Worker
C006325
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MH0150
—
AK
Enumeration date
11/30/2007
Last updated
07/03/2024
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