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Organization

EATING DISORDER CENTER OF MONTANA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JENI RUTH GOCHIN LMFT, LCPC (CLINICAL DIRECTOR)
(805) 637-4900
Entity
Organization

Contact information

Practice address
14 S WILLSON AVE, SUITE 102, BOZEMAN, MT 59715-6232
(805) 637-4900
(406) 551-1209
Mailing address
14 S WILLSON AVE, SUITE 102, BOZEMAN, MT 59715-6232
(805) 637-4900
(406) 551-1209

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
101YP2500X
Professional Counselor
103TC0700X
Clinical Psychologist
1041C0700X
Clinical Social Worker
133V00000X
Registered Dietitian
163WG0000X
General Practice Registered Nurse
2084P0800X
Psychiatry Physician
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
261QM1300X
Multi-Specialty Clinic/Center

Other

Enumeration date
06/29/2013
Last updated
08/28/2020
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