Healthcare Provider Details

I. General information

NPI: 1982617338
Provider Name (Legal Business Name): CHRISTINA CIPRIANO LCPC, NCC, CBIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 09/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 N HIGGINS AVE SUITE 307D
MISSOULA MT
59802-4465
US

IV. Provider business mailing address

127 N HIGGINS AVE SUITE 307D
MISSOULA MT
59802-4465
US

V. Phone/Fax

Practice location:
  • Phone: 406-241-3924
  • Fax:
Mailing address:
  • Phone: 406-241-3924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1151
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: