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Individual

DOMINGA MIA GROUND

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
SWLC

Contact information

Practice address
12 STARR SCHOOL ROAD, PO BOX 866, BROWNING, MT 59417-0866
(406) 845-4933
Mailing address
PO BOX 866, BROWNING, MT 59417-0866
(406) 845-4933

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
BBH-ACLC-LIC-72868
MT
1041C0700X
Clinical Social Worker
Primary
BBH-SWLC-LIC-72851
MT

Other

Enumeration date
10/09/2024
Last updated
08/21/2025
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