Individual
GLORIA RETA DENNIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.C.S.W.
Contact information
Practice address
2020 CHARLOTTE ST, BOZEMAN, MT 59718-2774
(406) 522-7682
Mailing address
8782 SYPES CANYON RD, BOZEMAN, MT 59715-8453
(406) 522-8656
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
534
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
71363
BLUECROSS BLUESHIELD
MT
Enumeration date
12/29/2006
Last updated
07/08/2007
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