Individual
MRS. NIKKI SUE LEWIS-CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED, LCPC
Contact information
Practice address
1915 12TH AVE S, GREAT FALLS, MT 59405-4804
(406) 231-2292
Mailing address
1915 12TH AVE S, GREAT FALLS, MT 59405-4804
(406) 231-2292
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
939
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0137319
—
MT
Enumeration date
01/30/2007
Last updated
02/08/2012
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