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Individual

ALLYSON NORWOOD BUSH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCPC

Contact information

Practice address
723 5TH AVE E # 10C, KALISPELL, MT 59901-5321
(406) 212-7576
Mailing address
306 5TH AVE E, KALISPELL, MT 59901-4925
(406) 212-7576

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1482
MT
101YP2500X
Professional Counselor
Primary
1482
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1477745370
MT
05
1861714537
MT
Enumeration date
02/23/2010
Last updated
10/25/2011
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