Individual
JUSTINA KELSEY DODGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
725 WEST CENTRAL AVE, #208, MISSOULA, MT 59801-6800
(406) 926-1231
(406) 926-1231
Mailing address
725 WEST CENTRAL AVENUE #208, MISSOULA, MT 59801-6800
(406) 926-1231
(406) 926-1231
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
18186
MT
1041C0700X
Clinical Social Worker
BBH-LCSW-LIC-18186
MT
Other
Enumeration date
08/17/2016
Last updated
09/05/2018
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