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Individual

ROBERTA (BOBBIE) JEANNE WENDEROTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, LCPC

Contact information

Practice address
1048 BURLINGTON AVE, SUITE 100, MISSOULA, MT 59801-5683
(406) 207-3342
(406) 721-3394
Mailing address
3624 SOUTH AVE W, MISSOULA, MT 59804-6310
(406) 207-3342
(406) 721-3394

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1276-LCPC
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0033761
MT
01
743580
BLUECROSS BLUESHIELD OF M
MT
Enumeration date
02/09/2007
Last updated
07/09/2007
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