Individual
DIANA PROEMM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CTRS
Contact information
Practice address
1831 BRISK CT, BOZEMAN, MT 59718-6146
(210) 400-0024
Mailing address
1831 BRISK CT, BOZEMAN, MT 59718-6146
(210) 400-0024
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
53226
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
53226
—
DC
Enumeration date
03/07/2019
Last updated
03/07/2019
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