Healthcare Provider Details

I. General information

NPI: 1407331010
Provider Name (Legal Business Name): JENNIFER LEIGH WILLS PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2018
Last Update Date: 02/12/2026
Certification Date: 02/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 4161
WHITEFISH MT
59937-4161
US

IV. Provider business mailing address

PO BOX 4161
WHITEFISH MT
59937-4161
US

V. Phone/Fax

Practice location:
  • Phone: 406-214-2505
  • Fax:
Mailing address:
  • Phone: 406-214-2505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY-PSY-LIC-3187
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: