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General NPI Number Information
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NPI Number | 1174149512
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Entity Type | Organization
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Legal Business Name | JESSICA CARDIFF,PC
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Dates
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Enumeration Date | 06/22/2020
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Last Update Date | 06/22/2020
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Provider Practice Location Address
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Address Line | 210 N HIGGINS AVE STE 227
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City | MISSOULA
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State | MT
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Zip | 59802-4497
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Country | US
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Telephone | 406-546-6791
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 18262
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City | MISSOULA
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State | MT
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Zip | 59808-8262
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | JESSICA CARDIFF
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Credential |
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Telephone | 406-546-6791
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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