Provider Demographics
NPI:1780056846
Name:REAL BIRD, NATALIE KIM (MS)
Entity type:Individual
Prefix:MS
First Name:NATALIE
Middle Name:KIM
Last Name:REAL BIRD
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 13TH ST W
Mailing Address - Street 2:
Mailing Address - City:HARDIN
Mailing Address - State:MT
Mailing Address - Zip Code:59034-2400
Mailing Address - Country:US
Mailing Address - Phone:406-665-7023
Mailing Address - Fax:
Practice Address - Street 1:10 W 4TH STREET SUITE B
Practice Address - Street 2:BIG HORN VALLEY HEALTH CENTER
Practice Address - City:HARDIN
Practice Address - State:MT
Practice Address - Zip Code:59034-1804
Practice Address - Country:US
Practice Address - Phone:406-665-4103
Practice Address - Fax:406-867-4103
Is Sole Proprietor?:No
Enumeration Date:2015-10-28
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT978101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)