Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 17585 | MT |
NPI | 1003266651 |
---|---|
Provider Name | William Walker |
First Address | Columbia Falls, MT 59912-3320 |
Second Address | Columbia Falls, MT 59912-3320 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2016 |
Last Update Date | 14/06/2016 |