Provider Demographics
NPI:1558485110
Name:GERTISER, DEBORAH ROYS (LCPC)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ROYS
Last Name:GERTISER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 E MAIN ST STE 207
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-4731
Mailing Address - Country:US
Mailing Address - Phone:406-587-5552
Mailing Address - Fax:
Practice Address - Street 1:321 E MAIN ST STE 207
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-4731
Practice Address - Country:US
Practice Address - Phone:406-587-5552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT722101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health