Individual
ROBIN LYNN LAINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
529 PARK AVE, SHELBY, MT 59474-2131
(208) 573-1066
Mailing address
PO BOX 1012, SHELBY, MT 59474-1012
(208) 573-1066
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
BBH-LAC-LIC-4927
MT
Other
Enumeration date
08/12/2017
Last updated
08/12/2017
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