Pedro, Janis M

Pedro, Janis M is an sole proprietor health care provider with primary practice located at 20 5Th Ave , Laurel MT 59044-2913. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Behavior Technician. Behavioral Health & Social Service Providers / Behavior Technician is her primary health care specialty. Pedro, Janis M can be contacted via phone (307) 272-5881.

Contact Information

Primary practice address
20 5Th Ave Laurel MT 59044-2913
Phone: (307) 272-5881
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 935 Montana
Behavioral Health & Social Service Providers / Clinical 1041C0700X LCSW-524 Wyoming
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X

Profile Details

NPI number 1104064195
LBN Legal business name Pedro, Janis M
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 28th, 2009
Last updated Aug 16th, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104064195 NPPES
Montana MEDICAID 1104064195

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