Individual
JENNIFER MARICELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
HHP,RMA
Contact information
Practice address
1620 REGENT ST STE B, MISSOULA, MT 59801-5685
(406) 370-0425
Mailing address
19820 RAMBLING ROSE LN, FLORENCE, MT 59833-6089
(406) 370-0425
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
53373505
TX
225400000X
Rehabilitation Practitioner
53373505
TX
251S00000X
Community/Behavioral Health Agency
53373505
TX
Other
Enumeration date
09/14/2018
Last updated
09/14/2018
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