Provider Demographics
NPI:1720481971
Name:GOLDING, ANNA
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:GOLDING
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 1:3255 LT MOSS RD
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59804-7220
Mailing Address - Country:US
Mailing Address - Phone:406-532-8953
Mailing Address - Fax:406-543-6751
Practice Address - Street 1:1325 WYOMING STREET
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MONTANA
Practice Address - Zip Code:59802
Practice Address - Country:UM
Practice Address - Phone:406-532-9817
Practice Address - Fax:406-541-3032
Is Sole Proprietor?:No
Enumeration Date:2014-10-02
Last Update Date:2014-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT4218101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)