| Doctor Name: | COLTON BRAGG HACKLEY |
| NPI Number: | 1619986056 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCPC |
| License Number: | 1265 |
| Business Practice Address: | 20 3rd St E Kalispell, MT - 599014573 |
| Business Phone Number: | 4067559471 |
| Business Fax Number: | 4067588113 |
| Mailing Address: | 1930 Teal Dr, KALISPELL |
| State: | MT |
| Postal Code: | 599017583 |
| Phone Number: | 4067551079 |
| Fax Number: | |
| NPI Enumeration Date: | 08/05/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | 1265 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |