Individual
HALEYANN BROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
800 KENSINGTON AVE, #100, MISSOULA, MT 59801-5674
(406) 239-5820
Mailing address
2801 HIGHCLIFF CT, #6, MISSOULA, MT 59808-9044
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OTP-OT-LIC-4704
MT
Other
Enumeration date
02/17/2017
Last updated
02/17/2017
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