Individual
MRS. DODIE A MOQUIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC LICENSE 616
Contact information
Practice address
210 N HIGGINS, #214, MISSOULA, MT 59801
(406) 721-6349
(406) 721-6349
Mailing address
10410 GRANT CREEK RD, MISSOULA, MT 59808
(406) 721-8466
(406) 721-8466
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
616
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0254774
—
MT
Enumeration date
11/27/2006
Last updated
07/08/2007
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