Healthcare Provider Details

I. General information

NPI: 1851940159
Provider Name (Legal Business Name): MOYRA M ANTHONY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2019
Last Update Date: 09/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2334 LEWIS AVE
BILLINGS MT
59102-3927
US

IV. Provider business mailing address

2334 LEWIS AVE
BILLINGS MT
59102-3927
US

V. Phone/Fax

Practice location:
  • Phone: 406-245-6539
  • Fax:
Mailing address:
  • Phone: 406-245-6539
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberBBH-LCSW-LIC-38884
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: