Individual
ALLEN REVARD HAZEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
723 5TH AVE E # B-18, KALISPELL, MT 59901-5321
(406) 249-4405
Mailing address
2202 WIDGEON CT, KALISPELL, MT 59901-8971
(406) 249-4405
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/24/2024
Last updated
06/09/2025
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