Individual
DEMETRIUS ALEXANDER FASSAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CBHPSS
Contact information
Practice address
609 W GALENA ST, BUTTE, MT 59701-1507
(406) 640-8069
(406) 303-5264
Mailing address
521 N EXCELSIOR AVE, BUTTE, MT 59701-8715
(859) 200-6861
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
BBH-BHPS-CRT-44134
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BBH-BHPS-CRT-44134
BOARD OF BEHAVIORAL HEALTH, CERTIFIED PEER SUPPORT SPECIALIST LICENSE #
MT
Enumeration date
11/03/2021
Last updated
11/03/2021
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