Individual
CRYSTAL MARIE WAVRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
619 SW HIGGINS AVE STE E, MISSOULA, MT 59803-1430
(406) 728-9672
Mailing address
4998 SONOMA ST, MISSOULA, MT 59808-8694
(406) 544-3551
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
BBH-LCSW-LIC-25772
MT
Other
Enumeration date
11/30/2017
Last updated
11/30/2017
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