Individual
KESHTISHA SUNDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1039 STONERIDGE DR STE 5, BOZEMAN, MT 59718-7056
(406) 624-6599
Mailing address
1039 STONERIDGE DR STE 5, BOZEMAN, MT 59718-7056
(406) 624-6599
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
PSY-BA-LIC-3188
MT
106S00000X
Behavior Technician
18-65321
MT
Other
Enumeration date
12/27/2019
Last updated
06/10/2020
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