Organization
LIFE SOURCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRED MICHAEL HUSKEY LCPC/CMHP (THERAPIST--PARTNER)
(406) 360-5481
Entity
Organization
Contact information
Practice address
127 W MAIN ST STE B-2, HAMILTON, MT 59840-2581
(770) 354-9621
Mailing address
PO BOX 127, HAMILTON, MT 59840-0127
(770) 354-9621
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
387-LCPC
MT
Other
Enumeration date
10/31/2017
Last updated
10/31/2017
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