Provider Demographics
NPI:1649558693
Name:PRAY, EMILY JANE (MSW)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:JANE
Last Name:PRAY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5931
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59806-5931
Mailing Address - Country:US
Mailing Address - Phone:406-241-4769
Mailing Address - Fax:
Practice Address - Street 1:725 W ALDER ST STE 10
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4099
Practice Address - Country:US
Practice Address - Phone:406-241-4769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-25
Last Update Date:2018-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCSW-LIC-78571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical