Organization
BLUEBIRD PSYCHOTHERAPY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IVY VANESSA IRVINE LCSW (OWNER)
(406) 546-0082
Entity
Organization
Contact information
Practice address
725 W ALDER ST, SUITE 28, MISSOULA, MT 59802-4036
(406) 546-0082
Mailing address
PO BOX 1384, LOLO, MT 59847-1384
(406) 546-0082
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
924
MT
Other
Enumeration date
01/05/2016
Last updated
01/05/2016
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