Provider Information for 1376291831
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JENNIFER VANCE SWLC
Sex: Female
NPI: 1376291831
Last Updated: 2022-03-14
Certification Date: 2022-03-14
Certification Date: 2022-03-14
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1376291831 | ||||||||
| Enumeration Date | 2022-03-14 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 3216 HOMER DAVIS RD SHEPHERD, MT 59079-4020 United States Phone: | Fax: | ||||||||
| Primary Practice Address | 32 WICKS LN BILLINGS, MT 59105-3810 United States Phone: 406-237-8359 | Fax: | ||||||||
| Secondary Practice Address(es) | 3216 HOMER DAVIS RD | ||||||||
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