Individual
THERESE DOLORES ETTEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
902 WYOMING AVENUE, BILLINGS, MT 59101
(406) 254-0192
(406) 254-0091
Mailing address
3209 DURLAND DRIVE, BILLINGS, MT 59102
(406) 655-3460
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
259
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0492235
—
MT
Enumeration date
04/23/2007
Last updated
07/08/2007
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