Individual
MRS. KRISTINA MARIE MINER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LAC, MSW
Contact information
Practice address
1600 NORTH AVE W STE 106, MISSOULA, MT 59801-5500
(406) 544-7678
(406) 926-3117
Mailing address
1600 NORTH AVE W STE 106, MISSOULA, MT 59801-5500
(406) 544-7678
(406) 926-3117
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1354
MT
1041C0700X
Clinical Social Worker
Primary
999
MT
Other
Enumeration date
07/27/2010
Last updated
01/21/2019
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