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General NPI Number Information
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NPI Number | 1043996622
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Entity Type | Organization
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Legal Business Name | ALIDA TROXELL THERAPY PLLC
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Dates
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Enumeration Date | 06/27/2023
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Last Update Date | 06/27/2023
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Provider Practice Location Address
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Address Line | 108 W RESERVE DR
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City | KALISPELL
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State | MT
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Zip | 59901-2118
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Country | US
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Telephone | 406-366-6109
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8556
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City | KALISPELL
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State | MT
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Zip | 59904-1556
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Country | US
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Telephone | 406-366-6109
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH COUNSEL
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Name | ALIDA M BOREN
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Credential | LCPC
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Telephone | 406-366-6109
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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