| NPI | 1518159433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL RAE BLANK Psychologist 406-587-7468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MT 202) |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2007-08-14 |