Individual
CAMILLE DEITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
17 2ND ST E STE 210, KALISPELL, MT 59901-4500
(406) 471-6844
Mailing address
17 2ND ST E STE 210, KALISPELL, MT 59901-4500
(406) 471-6844
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
BBH-PCLC-LIC-32538
MT
101YP2500X
Professional Counselor
Primary
BBH-LCPC-LIC-42981
MT
Other
Enumeration date
10/21/2019
Last updated
06/01/2020
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