Provider Information for 1043527302
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Mr. JEREMY ROYAL M.A., LCPC
Sex: Male
NPI: 1043527302
Last Updated: 2024-12-29
Certification Date: 2024-12-29
Certification Date: 2024-12-29
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1043527302 | ||||||||||||
| Enumeration Date | 2010-09-08 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 2300 N HARRIS ST UNIT 7886 HELENA, MT 59604-7480 United States Phone: 406-792-6472 | Fax: | ||||||||||||
| Primary Practice Address | 2300 N HARRIS ST UNIT 7886 HELENA, MT 59604-7480 United States Phone: 406-792-6472 | Fax: | ||||||||||||
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