Provider Demographics
NPI:1184909798
Name:SCHAFFNER, DENNISE MARIE (LAC)
Entity type:Individual
Prefix:MRS
First Name:DENNISE
Middle Name:MARIE
Last Name:SCHAFFNER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 2ND ST SE
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:MT
Mailing Address - Zip Code:59270-4305
Mailing Address - Country:US
Mailing Address - Phone:406-433-4097
Mailing Address - Fax:406-433-4726
Practice Address - Street 1:209 2ND ST SE
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:MT
Practice Address - Zip Code:59270-4305
Practice Address - Country:US
Practice Address - Phone:406-433-4097
Practice Address - Fax:406-433-4726
Is Sole Proprietor?:No
Enumeration Date:2011-10-14
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1382101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)