Healthcare Provider Details

I. General information

NPI: 1134915457
Provider Name (Legal Business Name): INNSAEI THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2025
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 W KAGY BLVD STE O
BOZEMAN MT
59715-6026
US

IV. Provider business mailing address

115 W KAGY BLVD STE O
BOZEMAN MT
59715-6026
US

V. Phone/Fax

Practice location:
  • Phone: 406-624-9629
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANYA R MOSES
Title or Position: CLINICIAN/ OWNER
Credential: LMFT
Phone: 406-624-9629