| Expanding Therapy Llc | |
|
526 Rollins St Missoula MT 59801-3721 | |
| (406) 213-5070 | |
| (406) 204-0237 |
| Full Name | Expanding Therapy Llc |
|---|---|
| Speciality | Social Worker |
| Location | 526 Rollins St, Missoula, Montana |
| Authorized Official Name and Position | Amber R Gladney (PROVIDER) |
| Authorized Official Contact | 4062135070 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Expanding Therapy Llc Po Box 865 Missoula MT 59806-0865 Ph: (406) 213-0570 | Expanding Therapy Llc 526 Rollins St Missoula MT 59801-3721 Ph: (406) 213-5070 |
| NPI Number | 1811656473 |
|---|---|
| Provider Enumeration Date | 12/10/2021 |
| Last Update Date | 12/10/2021 |
| Certification Date | 12/10/2021 |
| Medicare PECOS PAC ID | 7618368812 |
|---|---|
| Medicare Enrollment ID | O20211223000535 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811656473 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Amber Rose Gladney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972083079 PECOS PAC ID: 3678825452 Enrollment ID: I20181004003068 |
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