Individual
DANETTE M WOLLERSHEIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
129 W KENT AVE, STE I, MISSOULA, MT 59801-6730
(406) 542-7365
(406) 542-1032
Mailing address
129 W KENT AVE, STE I, MISSOULA, MT 59801-6730
(406) 542-7365
(406) 542-1032
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
249
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050841
BLUE CROSS
MT
05
—
493168
—
MT
Enumeration date
11/28/2006
Last updated
03/15/2017
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