Provider Information for 1831265420
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ANGELA WIDDICOMBE LCSW, LAC
Other Names:Former Name:ANGELA WHITECRANE LCSW, LACSex: Female
NPI: 1831265420
Last Updated: 2007-07-08
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1831265420 | ||||||||||||
| Enumeration Date | 2006-11-27 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 1008 BURLINGTON AVE SUITE C MISSOULA, MT 59801-5681 United States Phone: 888-850-4574 | Fax:406-542-2785 | ||||||||||||
| Primary Practice Address | 415 N HIGGINS AVE ROOM 110, HIGGINS PLAZA MISSOULA, MT 59802-4522 United States Phone: 406-360-0715 | Fax: | ||||||||||||
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