Individual
KELLY RIVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3335 LT MOSS RD, MISSOULA, MT 59804-7222
(406) 543-2202
Mailing address
3335 LT MOSS RD, MISSOULA, MT 59804-7222
(406) 543-2202
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
BBH-PCLC-LIC-81040
MT
Other
Enumeration date
08/22/2025
Last updated
08/22/2025
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