Provider Demographics
NPI:1154033389
Name:WOODEN LEGS-LOOKS BEHIND, DARLENE LOUISE
Entity type:Individual
Prefix:
First Name:DARLENE
Middle Name:LOUISE
Last Name:WOODEN LEGS-LOOKS BEHIND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 N 29TH ST STE 24
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-1924
Mailing Address - Country:US
Mailing Address - Phone:406-671-2122
Mailing Address - Fax:
Practice Address - Street 1:206 N 29TH ST STE 24
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-1924
Practice Address - Country:US
Practice Address - Phone:406-671-2122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist