Individual
BONITA MOSES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1305 WYOMING ST, MISSOULA, MT 59801-1725
(406) 532-9770
Mailing address
1305 WYOMING ST, MISSOULA, MT 59801-1725
(406) 532-9770
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
31639
MT
Other
Enumeration date
09/24/2018
Last updated
09/24/2018
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