Individual
REGINA MICHELLE ROOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
2016 N MERRILL AVE, GLENDIVE, MT 59330-2062
(406) 377-6075
(406) 377-6074
Mailing address
2508 WILSON ST, MILES CITY, MT 59301-5000
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3359
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3359
LAC LIC
MT
Enumeration date
11/02/2017
Last updated
11/02/2017
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