Individual
MR. ROB DEGOLIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
29 1/2 W COTTONWOOD DR, KALISPELL, MT 59901-2800
(406) 885-3726
Mailing address
PO BOX 10926, KALISPELL, MT 59904-3926
(406) 885-3726
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1143
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000076391
BLUE CROSS BLUE SHIELD
MT
05
—
0320372
—
MT
Enumeration date
03/08/2007
Last updated
06/19/2014
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