Doctor Name: | MRS. TRACI LYNN RICHARDS |
NPI Number: | 1073523346 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 678 |
Business Practice Address: | 106 W Broadway St Butte, MT - 597019224 |
Business Phone Number: | 4067235489 |
Business Fax Number: | 4067824020 |
Mailing Address: | T-9 Fort Missoula, MISSOULA |
State: | MT |
Postal Code: | 598047202 |
Phone Number: | 4065328400 |
Fax Number: | |
NPI Enumeration Date: | 08/09/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 678 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |