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Laverdure Psychiatry, Pllc

NPI Registration Record

Provider / OrganizationNPIDate Certified
LAVERDURE PSYCHIATRY, PLLC17408075022020-06-28
Entity TypeOrganization
Provider OrganizationLAVERDURE PSYCHIATRY, PLLC
Practice Office Address305 3RD AVE STE 316
HAVRE, MT US
Practice Office Telephone4063991932
Mailing Address66 15TH ST W
HAVRE, MT 595015274 US
Business Telephone4063991932
Authorized OfficialJENNIFER ANNE DURWARD, OWNER/PROVIDER
4063991932
HPT Codes
CodeLicense NoState
363LP0808X PRIMARY
193400000X SINGGroup Code
OPI Codes
Governmental Registrations [CAGE/NCAGE/DUNS]

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