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Individual

VINCENT JOHN ANTONICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LAC

Contact information

Practice address
501 EUCLID AVE, HELENA, MT 59601-2865
(406) 449-5796
Mailing address
501 EUCLID AVE, HELENA, MT 59601-2865
(406) 449-5796

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
49997
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
49997
LICENSED ADDICTIONS COUNSELOR
MT
Enumeration date
08/09/2021
Last updated
08/09/2021
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