Individual
TIMOTHY FOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
802 MAIN ST STE C, POLSON, MT 59860-3200
(406) 883-7310
(406) 883-7312
Mailing address
1321 WYOMING ST, MISSOULA, MT 59801-1725
(406) 532-8400
(406) 224-4402
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
38699
MT
Other
Enumeration date
07/29/2019
Last updated
07/29/2019
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