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General NPI Number Information
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NPI Number | 1346715612
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Entity Type | Organization
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Legal Business Name | LITTLE BIRD
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Dates
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Enumeration Date | 10/12/2018
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Last Update Date | 02/13/2019
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Provider Practice Location Address
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Address Line | 600 CENTRAL AVE STE 305
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City | GREAT FALLS
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State | MT
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Zip | 59401-3157
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Country | US
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Telephone | 406-315-4560
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 248
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City | BELT
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State | MT
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Zip | 59412-0248
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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 | CLINICAL SOCIAL WORKER
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Name | ELIZABETH CRABTREE
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Credential | LCSW
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Telephone | 406-315-4560
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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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