Healthcare Provider Details

I. General information

NPI: 1073627246
Provider Name (Legal Business Name): TARI KAY HEPPE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TARI KAY CHANDLER L.C.S.W.

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 11/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406 GARBER NO 1
PLAINS MT
59859-0011
US

IV. Provider business mailing address

PO BOX 11 406 GARBER NUMBER 1
PLAINS MT
59859-0011
US

V. Phone/Fax

Practice location:
  • Phone: 406-546-8095
  • Fax: 406-826-6826
Mailing address:
  • Phone: 406-546-8095
  • Fax: 406-826-6826

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number673LCSW
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: