Individual
MRS. JEANETTE K BLYTHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
35401 MISSION DRIVE, SAINT IGNATIUS, MT 59865-3649
(406) 745-3525
(406) 745-4409
Mailing address
PO BOX 880, SAINT IGNATIUS, MT 59865-0880
(406) 745-3525
(406) 745-4409
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
BBH-LAC-LIC-1087
MT
101YP2500X
Professional Counselor
BBH-PCLC-LIC-30656
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9901567
—
MT
Enumeration date
09/22/2015
Last updated
03/14/2024
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