Individual
ELIZABETH JENNIE DEFANTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
353 EVENING STAR LN, BOZEMAN, MT 59715-2108
(406) 586-9904
Mailing address
353 EVENING STAR LN, BOZEMAN, MT 59715-2108
(406) 586-9904
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0017525-1
NY
101YP2500X
Professional Counselor
Primary
1415
MT
101YP2500X
Professional Counselor
6566
NC
Other
Enumeration date
05/31/2010
Last updated
05/31/2010
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