MEDICARE: MISTI LEIGH HOFLAND MA, CRC, CH-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	62172	MT

General Provider Information

NPI Number	:	1720653207
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISTI LEIGH HOFLAND MA, CRC, CH-C

Provider Business Mailing Address
First Line	:	1337 AVENUE C NW
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59404-1735
Country	:	US
Telephone Number	:	406-750-8875
Fax Number	:

Provider Business Practice Location Address
First Line	:	1601 2ND AVE N STE 336
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59401-3243
Country	:	US
Telephone Number	:	406-750-8875
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2021
Last Update Date	:	12/15/2023

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Directions to “ MISTI LEIGH HOFLAND MA, CRC, CH-C” Practice Location

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