Individual provider · Type 1 NPI

Kimberly Wallis Panko, MA

Professional Counselor · Missoula, MT

NPI number 1245840230 Active

Practice location

7955 Toby Way
Missoula, MT 59808-5024

Call (406) 219-1302 Map

Mailing address

2814 Brooks St Ste 144
Missoula, MT 59801-7718

Specialties and licenses

TaxonomyCodeLicense
Counselor 101Y00000XBBH-LCPC-LIC-50086 (MT)
Addiction (Substance Use Disorder) Counselor 101YA0400X4630 (AK)
Mental Health Counselor 101YM0800X169890 (AK)
Professional Counselor Primary 101YP2500XBBH-LCPC-LIC-50086 (MT)

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About NPI 1245840230

Kimberly Wallis Panko, MA's National Provider Identifier is 1245840230, issued on Aug 4, 2020. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Missoula, MT. The record was last updated on Oct 24, 2024.