| NPI | 1881885382 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM LEROY SUDA President 406-363-2266 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MT 89) |
| Enumeration Date | 2007-08-08 |
| Last Update Date | 2007-08-08 |