Individual
MS. GWEN FARNSWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
30 FORT MISSOULA # 10, MISSOULA, MT 59804-7203
(406) 728-6065
Mailing address
30 FORT MISSOULA # 10, MISSOULA, MT 59804-7203
(406) 728-6065
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
588
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
254345
—
MT
Enumeration date
04/26/2007
Last updated
07/09/2007
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