De Groot, Petra Gerarda

De Groot, Petra Gerarda is an sole proprietor health care provider with primary practice located at 210 N Higgins Ave Suite 327, Missoula MT 59802-4462. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. De Groot, Petra Gerarda can be contacted via phone (406) 728-7584.

Contact Information

Primary practice address
210 N Higgins Ave Suite 327 Missoula MT 59802-4462
Phone: (406) 728-7584
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X MT 441 Montana

Profile Details

NPI number 1871706408
LBN Legal business name De Groot, Petra Gerarda
Credentials LCPC
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 8th, 2007
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871706408 NPPES
Montana Other 74933 BLUE CROSS & BLUE SHIELD

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