Individual
LAURA SANTA THUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LP
Contact information
Practice address
502 S 19TH AVE, BOZEMAN, MT 59718-4055
(315) 783-7374
Mailing address
280 W KAGY BLVD STE D126, BOZEMAN, MT 59715-6056
(406) 210-6964
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY-PSY-LIC-2507
MT
Other
Enumeration date
06/25/2008
Last updated
11/04/2018
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