Provider Demographics
NPI:1285007096
Name:FLICKINGER, JAMI
Entity Type:Individual
Prefix:
First Name:JAMI
Middle Name:
Last Name:FLICKINGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 E WASHINGTON ST STE A
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-3967
Mailing Address - Country:US
Mailing Address - Phone:406-351-0993
Mailing Address - Fax:
Practice Address - Street 1:30 E WASHINGTON ST STE A
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3967
Practice Address - Country:US
Practice Address - Phone:406-351-0993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-03
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT13149101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health