Terri L Gordon, MSW (STUDENT)

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Kalispell, MT

NPI 1366901720 · NPPES record last updated Mar 18, 2020

Key facts

NPI
1366901720
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
428 Church Dr
Kalispell, MT 59901-6955
Phone
(406) 607-7065
Fax
(406) 730-4050
NPI assigned
Mar 15, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Whole Health Healing LLC Past
since Feb 16, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

428 Church Dr
Kalispell, MT 59901-6955

Mailing address

428 Church Dr
Kalispell, MT 59901-6955
Phone (406) 241-4575

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address Terri.secondchances@outlook.com Direct

Other providers in Kalispell, MT

All providers in Kalispell, MT · Student in an Organized Health Care Education/Training Program in Montana

Sources for this page

Verify at the official NPI Registry.