Healthcare Provider Details

I. General information

NPI: 1063544054
Provider Name (Legal Business Name): NANCY K REPPE LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 8TH AVE N SUITE 203
GREAT FALLS MT
59401-1646
US

IV. Provider business mailing address

PO BOX 7297
GREAT FALLS MT
59406-7297
US

V. Phone/Fax

Practice location:
  • Phone: 406-452-1190
  • Fax: 406-452-1190
Mailing address:
  • Phone: 406-452-1190
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number435
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: