ANISA N GOFORTH

MISSOULA, MT
NPI1730585217
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy103T00000X Psychologist
(Licence: MT  1482)
Additional Taxonomies103TS0200X Psychologist, School
(Licence: MT  87674)
Enumeration Date2014-11-11
Last Update Date2014-11-11
Business Address
Dr. ANISA N GOFORTH PhD, NCSP
1444 MANSFIELD AVE
MISSOULA, MT 59812-0001
Phone number: 406-493-6471
Mailing Address
Dr. ANISA N GOFORTH PhD, NCSP
619 HOWELL ST
MISSOULA, MT 59802-2534
Phone number: 503-562-9379