Organization
MENDING MINDS THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTINA K HAGEN LCSW (LCSW)
(406) 926-1231
Entity
Organization
Contact information
Practice address
725 W CENTRAL AVE STE 208, MISSOULA, MT 59801-6800
(406) 926-1231
(406) 926-1231
Mailing address
725 W CENTRAL AVE STE 208, MISSOULA, MT 59801-6800
(406) 926-1231
(406) 926-1231
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
BBH-LCSW-LIC-18186
MT
Other
Enumeration date
12/08/2017
Last updated
12/08/2017
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