Individual
KELLY ANNE EWALT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
305 1ST AVE W, COLUMBIA FALLS, MT 59912-3619
(406) 249-9153
Mailing address
305 1ST AVE W, COLUMBIA FALLS, MT 59912-3625
(406) 249-9153
(406) 892-4606
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
683
MT
101YP2500X
Professional Counselor
Primary
683
MT
Other
Enumeration date
08/22/2010
Last updated
03/10/2024
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