Individual
IVAN MACDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSWE
Contact information
Practice address
830 W CENTRAL AVE, MISSOULA, MT 59801-7931
(406) 829-9515
Mailing address
2100 STEPHENS AVE STE 105&106, MISSOULA, MT 59801-6659
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/20/2019
Last updated
11/20/2019
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