Individual
WAVA E GOETZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
410 CENTRAL AVE, SUITE 509, GREAT FALLS, MT 59401-3154
(406) 761-7079
Mailing address
PO BOX 1077, GREAT FALLS, MT 59403-1077
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
490 LCPC
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
253422
—
MT
01
—
75283
BLUE CROSS BLUE SHIELD MT
MT
Enumeration date
01/09/2007
Last updated
07/08/2007
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