Individual
DERRICK ROBERT MOODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
153 WEDGEWOOD LN, KALISPELL, MT 59901-2643
(406) 290-9194
Mailing address
9705 LOST PRAIRIE RD, MARION, MT 59925-9844
(406) 601-8909
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
BBH-LCPC-LIC-77250
MT
Other
Enumeration date
01/22/2025
Last updated
11/10/2025
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