Individual
MR. MICHAEL JOHN PERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1180 VICKI DR, MISSOULA, MT 59804-3040
(406) 728-2148
Mailing address
1180 VICKI DR, MISSOULA, MT 59804-3040
(406) 728-2148
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
322
MT
Other
Enumeration date
12/03/2008
Last updated
12/03/2008
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