Female

Penni Spaan-raymond LCPC

Full Name

Penni Spaan-raymond LCPC

NPI Number

1053466144

NPI Type

Individual Provider

Gender

Female

Enumeration Date

01/25/2007

Specialties

(Taxonomies)

Code

101YM0800X
101YP2500X

Primary Taxonomy

No
No

Licenses

State

Montana

License Number

LCPC 1066

Contact
Information

Purpose

Mailing
Location

Address

PO BOX 9243
415 N HIGGINS AVE

City

Missoula
Missoula

State

MT
MT

Postal Code

59807-9243
59802-4522

Country

US
US

Telephone Number

(406) 728-0078
(406) 728-0078

Identifiers

Identifier

740640
0255748

Identifier State

MT
MT

Identifier Issuer

BLUE CROSS BLUE SHIELD
Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 07/08/2007

Provider Address