Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | SWP-LCPC-LIC-7854 | MT |
N | 225C00000X | Rehabilitation Counselor | 00111462 | MT |
NPI | 1073925350 |
---|---|
Provider Name | Pandora Kay Palmer |
First Address | Billings, MT 59102-1129 |
Second Address | Billings, MT 59101-1426 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2014 |
Last Update Date | 10/09/2014 |