Individual
MATT LASALLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
90 NAOMI ROSE LN, BOZEMAN, MT 59718-4590
(406) 813-0318
Mailing address
90 NAOMI ROSE LN, BOZEMAN, MT 59718-4590
(406) 813-0318
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
87961
MT
Other
Enumeration date
02/20/2026
Last updated
02/20/2026
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