Individual
TAMARA WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LAC, SWLC
Contact information
Practice address
4704 PARENT ST, MISSOULA, MT 59808-1472
(406) 241-0059
Mailing address
4704 PARENT ST, MISSOULA, MT 59808-1472
(406) 241-0059
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
64933
MT
1041C0700X
Clinical Social Worker
Primary
BBH-LCSW-LIC-72573
MT
Other
Enumeration date
11/13/2023
Last updated
10/23/2024
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