Individual
JACKSON MICAH HOKANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SWLC
Contact information
Practice address
30 E WASHINGTON ST STE A, KALISPELL, MT 59901-3967
(406) 471-4296
Mailing address
175 HUTTON RANCH RD, SUITE 103 #317, KALISPELL, MT 59901-2142
(406) 471-4296
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
BBH-SWLC-LIC-33249
MT
Other
Enumeration date
06/22/2019
Last updated
06/22/2019
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