| Doctor Name: | DOUGLAS RICHARDSON |
| NPI Number: | 1407220809 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 12428 |
| Business Practice Address: | 31469 Us Hwy 2 Libby, MT - 59923 |
| Business Phone Number: | 4062938746 |
| Business Fax Number: | 4062933862 |
| Mailing Address: | 380 Hutton Dr, LIBBY |
| State: | MT |
| Postal Code: | 599237727 |
| Phone Number: | 4064070880 |
| Fax Number: | |
| NPI Enumeration Date: | 11/23/2015 |
| NPI Last Update Date: | 11/23/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 12428 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |