Individual
CRISTIE POTRATZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1725 MT HIGHWAY 35, KALISPELL, MT 59901-2464
(406) 755-2425
Mailing address
3335 LT MOSS RD, MISSOULA, MT 59804-7222
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-73046
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-18-73046
REGISTERED BEHAVIOR TECHNICIAN NUMBER
—
Enumeration date
08/20/2020
Last updated
08/20/2020
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