Organization
EMBODIED WILD INTEGRATIVE COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA VISTE MA, PCLC (OWNER AND THERAPIST)
(406) 404-6629
Entity
Organization
Contact information
Practice address
415 N HIGGINS AVE, MISSOULA, MT 59802-4557
(406) 404-6629
Mailing address
PO BOX 17951, MISSOULA, MT 59808-7951
(406) 404-6629
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/13/2023
Last updated
03/13/2023
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