Individual
DESERIE BONNIE KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2210 MULLAN RD, MISSOULA, MT 59808-2059
(406) 493-7041
Mailing address
401 RAILROAD ST W, MISSOULA, MT 59802-4178
(406) 258-4789
(406) 258-4732
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
BBH-BHPS-CRT-78905
MT
Other
Enumeration date
04/30/2025
Last updated
04/30/2025
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