Individual
MR. KEVIN FORREST BERNARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S., L.C.P.C.
Contact information
Practice address
65A W KAGY BLVD, BOZEMAN, MT 59715-6052
(406) 582-7447
Mailing address
65A W KAGY BLVD, BOZEMAN, MT 59715-6052
(406) 582-7447
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
984
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
254643
—
MT
01
—
745023
BLUE CROSS BLUE SHIELD
MT
Enumeration date
04/10/2007
Last updated
07/09/2007
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