Individual
MELANIE MELLGREN-SIDMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC 4184
Contact information
Practice address
307 1ST AVE E STE 214, KALISPELL, MT 59901-4978
(406) 261-5005
Mailing address
307 1ST AVE E STE 214, KALISPELL, MT 59901-4978
(406) 261-5005
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LAC 4184
MT
Other
Enumeration date
08/12/2016
Last updated
08/12/2016
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