Doctor Name: | MR. CLARK PETER VOLKMANN |
NPI Number: | 1306069521 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCPC |
License Number: | 279 |
Business Practice Address: | 912 Main Ave Libby, MT - 599231820 |
Business Phone Number: | 4062934644 |
Business Fax Number: | 4062937644 |
Mailing Address: | 421 Milnor Lake Road, TROY |
State: | MT |
Postal Code: | 59935 |
Phone Number: | 4062955442 |
Fax Number: | 4062959655 |
NPI Enumeration Date: | 04/10/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 279 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |