Individual
MS. DANIELLE IRENE STANDLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
510 S 5TH ST W, MISSOULA, MT 59801-2618
(406) 203-2589
Mailing address
510 S 5TH ST W, MISSOULA, MT 59801-2618
(406) 203-2589
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
BBH-LAC-PRV-57370
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AAA0000091425
DRIVER'S LICENSE
MT
Enumeration date
11/15/2022
Last updated
11/15/2022
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