Individual
CORALIE LAEUPPLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
312 4TH AVE E, POLSON, MT 59860-2314
(406) 883-6229
(406) 883-6365
Mailing address
PO BOX 211, ELMO, MT 59915-0211
(406) 849-6121
(406) 494-1724
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
760
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
760
STATE OF MONTANA LICENSE
MT
Enumeration date
07/30/2007
Last updated
07/30/2007
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