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General NPI Number Information
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NPI Number | 1396159034
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Entity Type | Organization
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Legal Business Name | INNER CHILD INC
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Dates
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Enumeration Date | 06/19/2014
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Last Update Date | 06/19/2014
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Provider Practice Location Address
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Address Line | 3225 1ST AVE N STE 110
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City | BILLINGS
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State | MT
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Zip | 59101-2104
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Country | US
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Telephone | 406-655-0980
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Fax |
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Provider Business Mailing Address
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Address Line | 3225 1ST AVE N STE 110
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City | BILLINGS
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State | MT
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Zip | 59101-2104
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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 | OWNER
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Name | WENDY J. PAPA
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Credential | RN LCSW
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Telephone | 406-655-0980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 823
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License Number State | MT
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