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General NPI Number Information
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NPI Number | 1881403418
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Entity Type | Individual
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Provider Name | HAYLI VIRGINIA FUERTE
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Gender | Female
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Dates
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Enumeration Date | 01/07/2025
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 108 N. FRONT STREET SUITE C
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City | TOWNSEND, MT
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State | MT
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Zip | 59644
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Country | US
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Telephone | 406-980-0672
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Fax |
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Provider Business Mailing Address
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Address Line | 2 MURRAY LN
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City | CARDWELL
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State | MT
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Zip | 59721-9629
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Country | US
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Telephone | 425-420-7932
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | BBH-PCLC-LIC-78058
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License Number State | MT
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