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Individual

CYNTHIA LEE WILLENBROCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, LAC, PCLC

Contact information

Practice address
938 LONGSTAFF ST, MISSOULA, MT 59801-3602
(314) 306-5008
Mailing address
938 LONGSTAFF ST, MISSOULA, MT 59801-3602
(314) 306-5008

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
306543
MN
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
63194
MT
101YM0800X
Mental Health Counselor
64741
MT

Other

Enumeration date
10/02/2023
Last updated
10/02/2023
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