Individual
ANGELICA MARIE MOTHKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2809 CONNERY WAY STE B, MISSOULA, MT 59808-1955
(406) 552-9188
Mailing address
2501 HALF HITCH DR, MISSOULA, MT 59808-5438
(406) 552-9188
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
BBH-LCSW-LIC-31448
MT
Other
Enumeration date
07/18/2018
Last updated
06/17/2020
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