Goforth, Anisa N

Goforth, Anisa N is an sole proprietor health care provider with primary practice located at 1444 Mansfield Ave , Missoula MT 59812-0001. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / School. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Goforth, Anisa N can be contacted via phone (406) 493-6471.

Contact Information

Primary practice address
1444 Mansfield Ave Missoula MT 59812-0001
Phone: (406) 493-6471
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 1482 Montana
Behavioral Health & Social Service Providers / School 103TS0200X 87674 Montana

Profile Details

NPI number 1730585217
LBN Legal business name Goforth, Anisa N
Credentials PHD, NCSP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 11th, 2014
Last updated Nov 11th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Popular Providers