| Doctor Name: | MRS. KERI LYNN DEGROAT |
| NPI Number: | 1760781355 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | L.A.C. |
| License Number: | 1377 |
| Business Practice Address: | 310 S Main St Conrad, MT - 594252305 |
| Business Phone Number: | 4062890222 |
| Business Fax Number: | 4062787260 |
| Mailing Address: | 310 S Main St, CONRAD |
| State: | MT |
| Postal Code: | 594252305 |
| Phone Number: | 4062890222 |
| Fax Number: | 4062787260 |
| NPI Enumeration Date: | 03/22/2011 |
| NPI Last Update Date: | 03/22/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 1377 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |