Individual
MRS. RAPHAELLE BASSAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1315 E MAIN ST, BOZEMAN, MT 59715-3850
(406) 587-2477
Mailing address
1315 E MAIN ST, BOZEMAN, MT 59715-3850
(406) 587-2477
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/18/2021
Last updated
10/18/2021
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