| Cheryl Blank, Ph.d., P.c. | |
|
121 W Kagy Blvd Bozeman MT 59715-6000 | |
| (406) 587-7468 | |
| Not Available |
| Full Name | Cheryl Blank, Ph.d., P.c. |
|---|---|
| Speciality | Psychologist |
| Location | 121 W Kagy Blvd, Bozeman, Montana |
| Authorized Official Name and Position | Cheryl Rae Blank (PSYCHOLOGIST) |
| Authorized Official Contact | 4065877468 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cheryl Blank, Ph.d., P.c. 4744 Itana Cir Bozeman MT 59715-9330 Ph: () - | Cheryl Blank, Ph.d., P.c. 121 W Kagy Blvd Bozeman MT 59715-6000 Ph: (406) 587-7468 |
| NPI Number | 1518159433 |
|---|---|
| Provider Enumeration Date | 08/14/2007 |
| Last Update Date | 08/14/2007 |
| Medicare PECOS PAC ID | 4981613395 |
|---|---|
| Medicare Enrollment ID | O20060412000761 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518159433 | NPI | - | NPPES |
| 52820 | Other | MT | BLUE CROSS |
| 000085292 | Other | MT | 264349 |
| 0000490807 | Medicaid | MT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 202 (Montana) | Primary |
| Provider Name | Cheryl R Blank |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932221058 PECOS PAC ID: 0345259750 Enrollment ID: I20060413000411 |
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