Individual
MRS. ELLIE VICTORIA SHATTUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PCLC
Contact information
Practice address
1970 STADIUM DR STE B, BOZEMAN, MT 59715-0623
(704) 574-0383
Mailing address
500 WESTGATE AVE, BOZEMAN, MT 59718-2503
(704) 574-0383
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
BBH-PCLC-LIC-48422
MT
Other
Enumeration date
10/25/2023
Last updated
10/25/2023
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