Individual
ERLAND DALE KIDDIE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SOCIAL WORKER
Contact information
Practice address
310 S MERRIAM AVE, MILES CITY, MT 59301-4620
(406) 234-7521
Mailing address
310 S MERRIAM AVE, MILES CITY, MT 59301-4620
(406) 234-7521
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
122705-3502
UT
1041C0700X
Clinical Social Worker
Primary
404
MT
Other
Enumeration date
12/28/2007
Last updated
12/28/2007
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