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General NPI Number Information
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NPI Number | 1578706487
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Entity Type | Organization
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Legal Business Name | JOAN FITZGERALD, PC
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Dates
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Enumeration Date | 04/08/2009
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Last Update Date | 04/08/2009
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Provider Practice Location Address
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Address Line | 48 MEDICAL PARK DR
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City | HELENA
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State | MT
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Zip | 59601-4925
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Country | US
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Telephone | 406-449-3880
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Fax |
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Provider Business Mailing Address
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Address Line | 48 MEDICAL PARK DR
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City | HELENA
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State | MT
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Zip | 59601-4925
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Country | US
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Telephone | 406-449-3880
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOAN FITZGERALD
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Credential |
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Telephone | 406-449-3880
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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 | 238
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License Number State | MT
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