Individual
KATRENA DEZERAI PALMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
130 3RD ST S, GLASGOW, MT 59230-2303
(406) 228-9349
Mailing address
PO BOX 1530, MILES CITY, MT 59301-1530
(406) 234-0234
(406) 234-0235
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
71830
LAC LICENSE
MT
Enumeration date
12/27/2024
Last updated
12/27/2024
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