Individual
COLLEEN MARIE MCNULTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
1325 WYOMING ST, MISSOULA, MT 59801-1725
(406) 532-9770
(406) 541-3032
Mailing address
T-9 FORT MISSOULA, MISSOULA, MT 59804-7202
(406) 532-8400
(406) 543-9316
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1412
MT
Other
Enumeration date
11/21/2011
Last updated
11/21/2011
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