Individual
STACY A MCKITTRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACLC
Contact information
Practice address
26 4TH ST S, GREAT FALLS, MT 59401
(406) 727-2512
Mailing address
26 4TH ST S, GREAT FALLS, MT 59401
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37405
STATE OF MONTANA LICENSE
MT
Enumeration date
04/02/2019
Last updated
04/02/2019
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