Individual
MOLLY SIDDOWAY KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
104 E MAIN ST, SUITE 204, BOZEMAN, MT 59715-4760
(406) 587-8069
(406) 586-8327
Mailing address
104 E MAIN ST, SUITE 204, BOZEMAN, MT 59715-4760
(406) 587-8069
(406) 586-8327
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC - 669
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
74616
BCBS PROVIDER #
MT
Enumeration date
01/08/2007
Last updated
07/08/2007
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