| Doctor Name: | MYRON LITTLEBIRD |
| NPI Number: | 1326301599 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LAC |
| License Number: | 716 |
| Business Practice Address: | 28 Black Coal Dr Fort Washakie, WY - 825140638 |
| Business Phone Number: | 3073322203 |
| Business Fax Number: | |
| Mailing Address: | Po Box 638, 28 Black Coal Dr FORT WASHAKIE |
| State: | WY |
| Postal Code: | 825140638 |
| Phone Number: | 3073322203 |
| Fax Number: | |
| NPI Enumeration Date: | 06/21/2012 |
| NPI Last Update Date: | 06/21/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 716 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |