Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 1121 | MT |
NPI | 1477826931 |
---|---|
Provider Name | Lori A Ashton |
First Address | Great Falls, MT 59401-3752 |
Second Address | Great Falls, MT 59401-3752 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2012 |
Last Update Date | 14/02/2012 |