Individual
MS. LAURIE W THATCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
105 W MAIN ST, SUITE 2E, BOZEMAN, MT 59715-5016
(406) 580-9160
Mailing address
PO BOX 6774, BOZEMAN, MT 59771-6774
(406) 580-9160
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
461
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
501262
—
MT
01
—
70413
BCBS
MT
Enumeration date
12/18/2006
Last updated
07/08/2007
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