Doctor Name: | VICKI JOY DEBOER |
NPI Number: | 1043238611 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 299 |
Business Practice Address: | 420 W Mendenhall St Bozeman, MT - 597153449 |
Business Phone Number: | 4065871181 |
Business Fax Number: | 4065871801 |
Mailing Address: | 205 E Park Ave, ANACONDA |
State: | MT |
Postal Code: | 597112340 |
Phone Number: | 4065638117 |
Fax Number: | 4065635956 |
NPI Enumeration Date: | 07/18/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 299 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |