Provider Demographics
NPI:1073925350
Name:PALMER, PANDORA KAY (LCPC, CRC)
Entity Type:Individual
Prefix:
First Name:PANDORA
Middle Name:KAY
Last Name:PALMER
Suffix:
Gender:F
Credentials:LCPC, CRC
Other - Prefix:
Other - First Name:PANDORA
Other - Middle Name:KAY
Other - Last Name:ZIOKOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCPC,, CRC
Mailing Address - Street 1:3720 HAYDEN DR
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-1129
Mailing Address - Country:US
Mailing Address - Phone:406-698-0020
Mailing Address - Fax:
Practice Address - Street 1:615 N 19TH ST
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-1426
Practice Address - Country:US
Practice Address - Phone:406-698-1587
Practice Address - Fax:406-656-0935
Is Sole Proprietor?:No
Enumeration Date:2014-05-21
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTSWP-LCPC-LIC-7854101YP2500X
MT00111462225C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor