Stacy Jennings
Counselor, Professional in Missoula, MT. Individual provider (NPI-1).
NPI number1437571007
StatusActive
Last updated in NPPESJan 15, 2014
Details
- NPI
- 1437571007
- Entity type
- Individual (NPI-1)
- Name
- Stacy Jennings
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jan 15, 2014
- Last updated
- Jan 15, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 4670 | MT | Yes |
| 106H00000X | Marriage & Family Therapist | 4925 | MT |
Practice location
110 E Broadway St Ste 204Missoula, MT 59802-4592
Phone 406-370-4664
Mailing address
110 E Broadway St Ste 204Missoula, MT 59802-4592
Phone 406-370-4664
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