Individual
MS. JEANETTE STANGL INC PC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
821 SOUTH ORANGE STREET, SACAJAWEA OFFICES, MISSOULA, MT 59801
(406) 542-8461
(406) 542-7449
Mailing address
415 EAST KENT AVE, MISSOULA, MT 59801-6021
(406) 542-8461
(406) 542-7449
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
684LAC
MT
1041C0700X
Clinical Social Worker
Primary
454LCSW
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500973
—
MT
Enumeration date
09/29/2006
Last updated
09/25/2008
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