Provider Demographics
NPI:1679995930
Name:MORESI, RACHELLA
Entity Type:Individual
Prefix:
First Name:RACHELLA
Middle Name:
Last Name:MORESI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5606 FAIRVIEW LN
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:MT
Mailing Address - Zip Code:59833-6640
Mailing Address - Country:US
Mailing Address - Phone:406-360-5590
Mailing Address - Fax:
Practice Address - Street 1:5606 FAIRVIEW LN
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:MT
Practice Address - Zip Code:59833-6640
Practice Address - Country:US
Practice Address - Phone:406-360-5590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-06
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
MT1601101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional