| NPI | 1679812937 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | F TOM PETERSON Clinical Psychologist 406-232-1595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MT 119) |
| Enumeration Date | 2013-02-06 |
| Last Update Date | 2019-04-08 |