Organization
ROOTED IN CHANGE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANGELA PETERSEN PH.D. (PSYCHOLOGIST)
(858) 868-0364
Entity
Organization
Contact information
Practice address
422 W SPRUCE ST STOP C, MISSOULA, MT 59802-4141
(858) 868-0364
Mailing address
PO BOX 16592, MISSOULA, MT 59808-6592
(858) 868-0364
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
12/18/2023
Last updated
12/18/2023
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