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General NPI Number Information
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NPI Number | 1912164831
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Entity Type | Individual
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Provider Name | HILLARY SWAN FUNK WELZENBACH LCPC
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Gender | Female
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Dates
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Enumeration Date | 05/19/2008
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Last Update Date | 11/17/2020
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Provider Practice Location Address
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Address Line | 2237 S 3RD ST W
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City | MISSOULA
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State | MT
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Zip | 59801-1334
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Country | US
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Telephone | 406-541-2662
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Fax |
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Provider Business Mailing Address
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Address Line | 1515 E BROADWAY ST
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City | MISSOULA
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State | MT
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Zip | 59802-4929
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Country | US
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Telephone | 406-728-2662
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Fax | 406-728-2879
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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 | 1360
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License Number State | MT
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