Organization
BITTERROOT PSYCHOLOGICAL SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KAORU POWELL PHD (CLINICAL PSYCHOLOGIST)
(406) 219-5938
Entity
Organization
Contact information
Practice address
1444 MANSFIELD AVE, MISSOULA, MT 59812-0001
(406) 219-5938
Mailing address
201 TYLER WAY, LOLO, MT 59847-9794
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
Other
Enumeration date
10/10/2023
Last updated
11/07/2023
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