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General NPI Number Information
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NPI Number | 1669144812
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Entity Type | Organization
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Legal Business Name | HEAD AND HEART
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Dates
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Enumeration Date | 10/05/2021
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Last Update Date | 08/31/2022
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Provider Practice Location Address
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Address Line | 215 3RD AVE E
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City | KALISPELL
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State | MT
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Zip | 59901-4531
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Country | US
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Telephone | 406-871-5605
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Fax |
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Provider Business Mailing Address
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Address Line | 15141 MT HIGHWAY 35
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City | BIGFORK
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State | MT
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Zip | 59911-8482
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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 | EXECUTIVE DIRECTOR
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Name | COLBY WOOD
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Credential | LCSW
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Telephone | 406-871-5605
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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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