Provider Demographics
NPI:1174777221
Name:KELSCH, DONNA MARIE (EDD)
Entity type:Individual
Prefix:DR
First Name:DONNA
Middle Name:MARIE
Last Name:KELSCH
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 N 19TH AVE
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-6928
Mailing Address - Country:US
Mailing Address - Phone:406-404-1009
Mailing Address - Fax:480-773-8386
Practice Address - Street 1:804 N 19TH AVE
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-6928
Practice Address - Country:US
Practice Address - Phone:406-404-1009
Practice Address - Fax:480-773-8386
Is Sole Proprietor?:No
Enumeration Date:2008-11-14
Last Update Date:2015-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
No101Y00000XBehavioral Health & Social Service ProvidersCounselor