Individual
BONNIE L. MALCOLM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
606 SOUTH AVE W, MISSOULA, MT 59801-8013
(406) 240-0996
Mailing address
606 SOUTH AVE W, MISSOULA, MT 59801-8013
(406) 240-0996
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCSW 707
MT
Other
Enumeration date
03/04/2008
Last updated
03/04/2008
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