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Individual

LACEE ANN GEORGE GENGENBACHER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS

Contact information

Practice address
19 N 10TH AVE STE 5, BOZEMAN, MT 59715-3260
(406) 422-7678
Mailing address
311 MICHAEL GROVE AVE APT A, BOZEMAN, MT 59718-3682
(406) 422-7678

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4689
MT

Other

Enumeration date
06/05/2012
Last updated
11/07/2024
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