Provider Demographics
NPI:1124291620
Name:THRESHOLD VOCATIONAL SERVICES, PLLC
Entity type:Organization
Organization Name:THRESHOLD VOCATIONAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VOCATIONAL COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:WALLETTE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CRC
Authorized Official - Phone:406-756-0990
Mailing Address - Street 1:PO BOX 1120
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59903-1120
Mailing Address - Country:US
Mailing Address - Phone:406-756-0990
Mailing Address - Fax:406-756-7440
Practice Address - Street 1:445 MAIN ST
Practice Address - Street 2:SUITE 202
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-4872
Practice Address - Country:US
Practice Address - Phone:406-756-0990
Practice Address - Fax:406-756-7440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-07
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT31731225C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorGroup - Single Specialty