Organization
MISSOULA FAMILY THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STACY JENNINGS M.S. (LMFT, LCPC)
(406) 370-4664
Entity
Organization
Contact information
Practice address
110 E BROADWAY ST STE 204, MISSOULA, MT 59802-4592
(406) 370-4664
Mailing address
110 E BROADWAY ST STE 204, MISSOULA, MT 59802-4592
(406) 370-4664
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
SWPLCPCLIC4670
MT
Other
Enumeration date
11/27/2013
Last updated
01/15/2014
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