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ROBERT HANLEY LAC

Addiction (Substance Use Disorder) >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1578696464

Individual Registrant:
 ROBERT  HANLEY LAC
Gender: M
Not Sole Proprietor

Location and contact information for practice:
711 CALIFORNIA AVENUE  LIBBY, NE 59923 US
Tel: 406-293-7731  Fax: 406-293-2823

Contact information for business:
711 CALIFORNIA AVE  LIBBY, MT 59923-1903 US
Tel: 406-293-7731  Fax: 406-293-2823

Registration Information:
NPI: 1578696464
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)
MT1093

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
0320372MT05
BLUE CROSS BLUE SHIELD0000076391MT01




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