Provider Demographics
NPI:1639453897
Name:OPITZ, ANGELA GIULIANI (LCPC)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:GIULIANI
Last Name:OPITZ
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 1:110 S GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-4616
Mailing Address - Country:US
Mailing Address - Phone:406-732-6716
Mailing Address - Fax:
Practice Address - Street 1:110 S GRAND AVE
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-4616
Practice Address - Country:US
Practice Address - Phone:406-360-4006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-06
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1524101YP2500X
MTBBH-LCPC-1524101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional