Provider Demographics
NPI:1902440217
Name:HARTFORD, KIRA LEIGH
Entity Type:Individual
Prefix:
First Name:KIRA
Middle Name:LEIGH
Last Name:HARTFORD
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 1:1212 HELENA AVE
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-2948
Mailing Address - Country:US
Mailing Address - Phone:406-443-7370
Mailing Address - Fax:
Practice Address - Street 1:1212 HELENA AVE
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-2948
Practice Address - Country:US
Practice Address - Phone:406-443-7370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-30
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician