| NPI | 1801062096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HALLIE ALYSSA BORNSTEIN BANZIGER Owner 406-219-3311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MT 366) |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2008-10-22 |