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General NPI Number Information
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NPI Number | 1306396924
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Entity Type | Organization
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Legal Business Name | MEGAN BAKER WELLES INTEGRATIVE COUNSELING, LLC
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Dates
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Enumeration Date | 10/06/2016
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Last Update Date | 10/06/2016
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Provider Practice Location Address
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Address Line | 145 NORTHRIDGE DR
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City | KALISPELL
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State | MT
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Zip | 59901-2634
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Country | US
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Telephone | 406-407-0935
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Fax |
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Provider Business Mailing Address
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Address Line | 145 NORTHRIDGE DR
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City | KALISPELL
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State | MT
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Zip | 59901-2634
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Country | US
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Telephone | 406-407-0935
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Fax |
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Authorized Official
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Title or Position | PROFESSIONAL COUNSELOR
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Name | MEGAN K BAKER WELLES
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Credential | LCPC, LMFT
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Telephone | 406-407-0935
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 19005
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License Number State | MT
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