Individual
JOHANNA CRISTOL LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
601 W SPRUCE ST STE A, MISSOULA, MT 59802-4047
(406) 728-3111
(406) 728-3116
Mailing address
PO BOX 12, LIBERTY LAKE, WA 99019-0012
(406) 728-3111
(406) 728-3116
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
BBH-LCSW-LIC-55228
MT
Other
Enumeration date
02/16/2022
Last updated
02/28/2022
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