GERALD BRENT RUDOLPH

BOZEMAN, MT
NPI1366295180
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MT  BBH-LAC-LIC-70217)
Enumeration Date2024-04-10
Last Update Date2024-05-21
Business Address
GERALD BRENT RUDOLPH LAC
2216 BOOTHILL CT STE 3
BOZEMAN, MT 59715-7215
Phone number: 406-600-5007
Mailing Address
GERALD BRENT RUDOLPH LAC
2216 BOOTHILL CT STE 3
BOZEMAN, MT 59715-7215
Phone number: 406-600-5007