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General NPI Number Information
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NPI Number | 1942714902
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Entity Type | Organization
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Legal Business Name | PATRICIA FLYNN, LAC
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Dates
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Enumeration Date | 11/28/2017
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Last Update Date | 11/28/2017
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Provider Practice Location Address
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Address Line | 1629 AVENUE D STE B4
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City | BILLINGS
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State | MT
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Zip | 59102-3071
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Country | US
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Telephone | 406-850-4477
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 20368
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City | BILLINGS
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State | MT
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Zip | 59104-0368
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Country | US
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Telephone | 406-850-4477
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Fax |
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Authorized Official
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Title or Position | OWNER/LAC
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Name | PATRICIA FLYNN
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Credential | LAC
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Telephone | 406-850-4477
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | 0000309
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License Number State | MT
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