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Individual

PENNY M GIFFORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCPC

Contact information

Practice address
336 W. SPRUCE, MISSOULA, MT 59802
(970) 217-8686
(844) 587-9638
Mailing address
PO BOX 1371, MISSOULA, MT 59806
(970) 217-8686
(844) 587-9638

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
4727
MT
101YP2500X
Professional Counselor
5992
CO
101YP2500X
Professional Counselor
Primary
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7168109
MT
Enumeration date
06/25/2007
Last updated
02/08/2016
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