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Individual

TIMOTHY P HERZOG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
EDD, LCPC, CMPC, BCB

Contact information

Practice address
2018 STADIUM DR, SUITE B, BOZEMAN, MT 59715-0706
(406) 587-3404
Mailing address
2152 RENARD CT, ANNAPOLIS, MD 21401-6756
(410) 980-2014

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1334
MT
103TC1900X
Counseling Psychologist
Primary
0810006445
VA

Other

Enumeration date
09/29/2008
Last updated
02/07/2024
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