Provider Demographics
NPI:1558372490
Name:VOS-FERNEAU, JUDITH C (MSW, LCPC, OTR/L RYT)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:C
Last Name:VOS-FERNEAU
Suffix:
Gender:F
Credentials:MSW, LCPC, OTR/L RYT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:T-9 FORT MISSOULA
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59804-7202
Mailing Address - Country:US
Mailing Address - Phone:406-532-8400
Mailing Address - Fax:
Practice Address - Street 1:106 W BROADWAY ST
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-9224
Practice Address - Country:US
Practice Address - Phone:406-723-5489
Practice Address - Fax:406-782-4020
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT7751041C0700X
MT1263101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional