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3335 Lt Moss Rd Missoula MT 59804-7222 | |
| (406) 549-6413 | |
| (406) 542-0143 |
| Full Name | |
|---|---|
| Speciality | Behavior Analyst |
| Location | 3335 Lt Moss Rd, Missoula, Montana |
| Authorized Official Name and Position | Julie Gilchrist (INSURANCE SERVICES ADMINISTRATOR) |
| Authorized Official Contact | 4065496413 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3335 Lt Moss Rd Missoula MT 59804-7222 Ph: (406) 549-6413 | 3335 Lt Moss Rd Missoula MT 59804-7222 Ph: (406) 549-6413 |
| NPI Number | 1750422978 |
|---|---|
| Provider Enumeration Date | 02/09/2007 |
| Last Update Date | 06/19/2023 |
| Certification Date | 06/19/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750422978 | NPI | - | NPPES |
| 601851 | Medicaid | MT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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