Most Relevant Information
Provider Data
| NPI Number: | 1003646019 |
| Provider Name: | KAITLYN NINA BOSSHARDT LMSW |
| Entity Type: | Individual |
| Taxonomy Code: | 104100000X |
| Specialty: | Social Worker |
| License Number: | BBH-LMSW-LIC-70555 |
Most Important Dates
| Enumeration Date: | 08/05/2024 |
| Last Updated: | 08/05/2024 |
Provider Practice Location
401 RAILROAD ST W
MISSOULA
MT
598024178
Practice Location Phone/Fax
| Phone: | 4062584789 |
| Fax: | 4062584732 |
Provider Mailing Location
401 RAILROAD ST W
MISSOULA
MT
598024178
Provider Mailing Phone/Fax
| Phone: | 4062584789 |
| Fax: | 4062584732 |