Individual
CHARLES WAYLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1365 SUNFLOWER DR, MISSOULA, MT 59802-3309
(406) 396-7834
Mailing address
336 W SPRUCE ST, MISSOULA, MT 59802-4108
(406) 396-7834
(406) 721-2833
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1050
MT
Other
Enumeration date
02/03/2012
Last updated
01/03/2017
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