Organization
GOOD MEDICINE THERAPY CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTINA J NELSON MSW,LCSW.LAC,CMHP (THERAPIST)
(406) 293-7116
Entity
Organization
Contact information
Practice address
803 LOUISIANA AVE, LIBBY, MT 59923-2107
(406) 293-7116
(406) 293-4029
Mailing address
803 LOUISIANA AVE, LIBBY, MT 59923-2107
(406) 293-7116
(406) 293-4029
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
799LCSW
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0044707
—
MT
Enumeration date
09/07/2007
Last updated
09/07/2007
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