Individual
KELLEY M DONISTHORPE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, LCPC
Contact information
Practice address
103 BEN HOGAN DR, MISSOULA, MT 59803-2422
(406) 531-2421
Mailing address
PO BOX 3043, MISSOULA, MT 59806-3043
(406) 531-2421
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
BBH-LCPC-LIC-54991
MT
Other
Enumeration date
01/20/2022
Last updated
01/20/2022
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