Individual
CARLY KLEINERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1325 WYOMING ST, MISSOULA, MT 59801-1725
(406) 532-9800
Mailing address
2677 PALMER ST STE 300, MISSOULA, MT 59808-1700
(406) 329-1543
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
BBH-LAC-LIC-16926
MT
Other
Enumeration date
10/02/2018
Last updated
10/02/2018
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