Individual
LEIF HALLBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
416 N IDA AVE, BOZEMAN, MT 59715-3016
(406) 600-2004
Mailing address
416 N IDA AVE, BOZEMAN, MT 59715-3016
(406) 600-2004
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
BBH-LCPC-LIC-12379
MT
101YM0800X
Mental Health Counselor
C2986
OR
Other
Enumeration date
10/22/2009
Last updated
05/04/2016
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