Provider Demographics
NPI:1295217495
Name:PULLOM, RANA HELEN (MSW)
Entity Type:Individual
Prefix:
First Name:RANA
Middle Name:HELEN
Last Name:PULLOM
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:RANA
Other - Middle Name:HELEN
Other - Last Name:GARRETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:1940 W DICKERSON ST STE 207
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-6851
Mailing Address - Country:US
Mailing Address - Phone:509-201-9134
Mailing Address - Fax:
Practice Address - Street 1:1940 W DICKERSON ST STE 207
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-6851
Practice Address - Country:US
Practice Address - Phone:509-201-9134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-04
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW611640161041C0700X
MT544871041C0700X
WASC60904355101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical