Provider Demographics
NPI:1972183150
Name:KINNAMAN, AARON PHILIP
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:PHILIP
Last Name:KINNAMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 10TH AVE S STE 200
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-2619
Mailing Address - Country:US
Mailing Address - Phone:406-866-0350
Mailing Address - Fax:
Practice Address - Street 1:1500 10TH AVE S STE 200
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-2619
Practice Address - Country:US
Practice Address - Phone:406-866-0350
Practice Address - Fax:406-403-0263
Is Sole Proprietor?:No
Enumeration Date:2021-04-12
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health