Individual
MRS. JACQUELINE L CONNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
525 N. PRATTEN, COLUMBUS, MT 59019-7148
(406) 322-4789
(406) 322-4789
Mailing address
525 N. PRATTEN, COLUMBUS, MT 59019-7148
(406) 322-4789
(406) 322-4789
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
781
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0530725
—
MT
01
—
660220
BCBS
MT
Enumeration date
04/19/2007
Last updated
07/08/2007
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