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1871706408
PETRA GERARDA DE GROOT
MISSOULA, MT
NPI
1871706408
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Other Name
PETRONELLA G DEGROOT
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: MT MT 441)
Enumeration Date
2007-05-08
Last Update Date
2007-07-08
Business Address
Ms. PETRA GERARDA DE GROOT LCPC
210 N HIGGINS AVE SUITE 327
MISSOULA, MT 59802-4462
Phone number: 406-728-7584
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Mailing Address
Ms. PETRA GERARDA DE GROOT LCPC
PO BOX 8388
MISSOULA, MT 59807-8388
Phone number: 406-728-7584
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