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Organization

MEDICINE LODGE COUNSELING PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PAMELA C WILSON LCPC LAC (CLINICAL MENTAL HEALTH COUNSELOR)
(406) 360-8470
Entity
Organization

Contact information

Practice address
2809 GREAT NORTHERN LOOP STE 210-5, MISSOULA, MT 59808-1749
(406) 360-8470
Mailing address
14098 JENNY ANN CT UNIT A, MISSOULA, MT 59808-5386
(406) 360-8470

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4654
MT

Other

Enumeration date
04/24/2018
Last updated
06/16/2018
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