Provider Information for 1649041955
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JUSTIN YAVORSKI LCPC
Sex: Male
NPI: 1649041955
Last Updated: 2025-03-03
Certification Date: 2025-03-03
Certification Date: 2025-03-03
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1649041955 | ||||||||||||
| Enumeration Date | 2024-01-15 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 1800 S. 22ND AVE. STE 120 #175 BOZEMAN, MT 59718-5837 United States Phone: 406-312-9951 | Fax: | ||||||||||||
| Primary Practice Address | 1871 S 22ND AVE STE 1A BOZEMAN, MT 59718-7054 United States Phone: 406-312-9951 | Fax: | ||||||||||||
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