Individual
JO-LYNN PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA LCPC
Contact information
Practice address
1605 DANIELSON RD, KALISPELL, MT 59901-7252
(406) 758-8122
Mailing address
723 5TH AVE E UNIT 314C, KALISPELL, MT 59901-5328
(970) 759-8227
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
SWP-LCPC-LIC-6402
MT
Other
Enumeration date
01/15/2014
Last updated
01/15/2014
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