Jessica Michaela Hennager

Individual provider Active NPI Child Mental Illness Respite Care · Corvallis, MT

NPI 1962931154 · NPPES record last updated Jun 9, 2017

Key facts

NPI
1962931154
Entity type
Individual (NPI type 1)
Primary specialty
Child Mental Illness Respite Care 385HR2055X
Practice address
2200 Eastside Hwy
Corvallis, MT 59828-9616
Phone
(406) 360-8221
Fax
(406) 360-8221
NPI assigned
Jun 9, 2017
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Child Mental Illness Respite Care 385HR2055X Yes

Addresses

Primary practice location

2200 Eastside Hwy
Corvallis, MT 59828-9616

Mailing address

2200 Eastside Hwy
Corvallis, MT 59828-9616
Phone (406) 360-8221

Other providers in Corvallis, MT

All providers in Corvallis, MT · Child Mental Illness Respite Care in Montana

Sources for this page

Verify at the official NPI Registry.