Individual
COLTON BRAGG HACKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
20 3RD ST E, KALISPELL, MT 59901-4573
(406) 755-9471
(406) 758-8113
Mailing address
1930 TEAL DR, KALISPELL, MT 59901-7583
(406) 755-1079
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
1265
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0255374
—
MT
Enumeration date
08/05/2006
Last updated
07/09/2007
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