Healthcare Provider Details

I. General information

NPI: 1881386076
Provider Name (Legal Business Name): ANNIE FLORIN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2023
Last Update Date: 09/27/2023
Certification Date: 09/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2809 CONNERY WAY STE B
MISSOULA MT
59808-1955
US

IV. Provider business mailing address

PO BOX 3291
MISSOULA MT
59806-3291
US

V. Phone/Fax

Practice location:
  • Phone: 406-219-1267
  • Fax:
Mailing address:
  • Phone: 406-219-1267
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ANNE FLORIN
Title or Position: OWNER
Credential:
Phone: 406-219-1267