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General NPI Number Information
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NPI Number | 1760706535
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Entity Type | Organization
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Legal Business Name | ART WORKS COUNSELING SERVICE LLC
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Dates
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Enumeration Date | 03/23/2010
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Last Update Date | 03/23/2010
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Provider Practice Location Address
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Address Line | 520 N PATTEE ST
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City | MISSOULA
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State | MT
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Zip | 59802-4516
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Country | US
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Telephone | 406-493-7313
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Fax |
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Provider Business Mailing Address
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Address Line | 520 N PATTEE ST
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City | MISSOULA
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State | MT
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Zip | 59802-4516
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Country | US
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Telephone | 406-493-7313
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. LAURIE C BOGART
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Credential | LCPC
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Telephone | 406-493-7313
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 788
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License Number State | MT
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