Lily Gervais Lcsw, Lac Pllc
Mental Health Counselor in Missoula, MT(View on Map)
Legal Business Name
Lily Gervais Lcsw, Lac Pllc
NPI Number
1154174837
NPI Type
Organization
Enumeration Date
04/10/2024
Specialties
(Taxonomies)Code
101YM0800X
251S00000X
Primary Taxonomy
Yes
No
Contact
Information
Purpose
Mailing
Location
Address
5767 W HARRIER DR
5767 W HARRIER DR
City
Missoula
Missoula
State
MT
MT
Postal Code
59808-1053
59808-1053
Country
US
US
Telephone Number
(406) 546-9257
(406) 546-9257
Authorized Official
Name
Lily Gervais
Title or Position
OWNER
Telephone Number
(406) 546-9257
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 06/12/2024
Provider Address
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