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Individual

JILL SHAVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ACC

Contact information

Practice address
285 2ND AVENUE WN, SUITE #100, KALISPELL, MT 59901
(304) 273-0112
Mailing address
285 2ND AVENUE WN, SUITE #100, KALISPELL, MT 59901

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16383
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
16383
MONTANA BOARD OF BEHAVIORAL HEALTH
MT
Enumeration date
04/19/2017
Last updated
04/19/2017
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