Individual
REVA PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2050 FAIRWAY DR, #208, BOZEMAN, MT 59715-5871
(406) 586-3308
Mailing address
2050 FAIRWAY DR, #208, BOZEMAN, MT 59715-5871
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LCPC#365
MT
Other
Enumeration date
03/14/2008
Last updated
11/13/2008
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