Individual
JENNIE EILEEN BONDURANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATS, LAC
Contact information
Practice address
1312 N MERIDIAN RD, KALISPELL, MT 59901-3095
(406) 756-6453
(406) 756-8546
Mailing address
PO BOX 7115, KALISPELL, MT 59904-0115
(406) 756-6453
(406) 756-8546
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
30018
MT
Other
Enumeration date
04/16/2018
Last updated
04/16/2018
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