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General NPI Number Information
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NPI Number | 1679614341
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Entity Type | Organization
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Legal Business Name | VIRGINIA SPRADLIN
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 01/08/2014
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Provider Practice Location Address
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Address Line | 236 WISCONSIN AV
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City | WHITEFISH
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State | MT
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Zip | 59937
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Country | US
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Telephone | 406-862-4077
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 815
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City | WHITEFISH
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State | MT
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Zip | 59937-0815
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Country | US
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Telephone | 406-862-4077
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Fax |
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | VIRGINIA SPRADLIN
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Credential | LCSW
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Telephone | 406-862-4077
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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 | 604
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License Number State | MT
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