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Organization

REACHING AHEAD PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TIMOTHY HERZOG L.C.P.C. (COUNSELOR)
(406) 587-3404
Entity
Organization

Contact information

Practice address
2018 STADIUM DR STE B, BOZEMAN, MT 59715-0706
(406) 587-3404
Mailing address
2018 STADIUM DR STE B, BOZEMAN, MT 59715-0706
(406) 587-3404

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1334-LCPC
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1334-LCPC
LCPC-MONTANA
MT
Enumeration date
09/24/2008
Last updated
09/24/2008
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