Glenn Jacob Fairhurst
Counselor, Mental Health in Great Falls, MT. Individual provider (NPI-1).
NPI number1982467361
StatusActive
Last updated in NPPESJan 30, 2024
Details
- NPI
- 1982467361
- Entity type
- Individual (NPI-1)
- Name
- Glenn Jacob Fairhurst
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 30, 2024
- Certification date
- Jan 30, 2024
- Last updated
- Jan 30, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | BBHPCLCLIC70082 | MT | Yes |
Practice location
33 Division Rd Unit 1Great Falls, MT 59404-1410
Phone 406-781-2074
Mailing address
33 Division Rd Unit 1Great Falls, MT 59404-1410
Phone 406-781-2074
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