| Doctor Name: | MS. TAMI ELLISON CONRAD |
| NPI Number: | 1942453915 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 1386 |
| Business Practice Address: | 405 Ryan Dr Glendive, MT - 593303805 |
| Business Phone Number: | 4063772587 |
| Business Fax Number: | |
| Mailing Address: | Po Box 85, GLENDIVE |
| State: | MT |
| Postal Code: | 593300085 |
| Phone Number: | 4063772587 |
| Fax Number: | |
| NPI Enumeration Date: | 11/03/2008 |
| NPI Last Update Date: | 11/03/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 1386 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |