| Michele C. Mckinnie, Psy.d., Pc | |
|
1648 Ellis St Suite 302 Bozeman MT 59715-8810 | |
| (406) 582-1321 | |
| (406) 587-1513 |
| Full Name | Michele C. Mckinnie, Psy.d., Pc |
|---|---|
| Speciality | Psychologist |
| Location | 1648 Ellis St, Bozeman, Montana |
| Authorized Official Name and Position | Michele Catherine Mckinnie (PSYCHOLOGIST/OWNER) |
| Authorized Official Contact | 4065821321 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michele C. Mckinnie, Psy.d., Pc 1648 Ellis St Suite 302 Bozeman MT 59715-8810 Ph: (406) 582-1321 | Michele C. Mckinnie, Psy.d., Pc 1648 Ellis St Suite 302 Bozeman MT 59715-8810 Ph: (406) 582-1321 |
| NPI Number | 1083896757 |
|---|---|
| Provider Enumeration Date | 12/04/2007 |
| Last Update Date | 12/04/2007 |
| Medicare PECOS PAC ID | 2668412339 |
|---|---|
| Medicare Enrollment ID | O20071211000080 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083896757 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 338 (Montana) | Primary |
| Provider Name | Michele C Mckinnie |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1902969983 PECOS PAC ID: 9537146097 Enrollment ID: I20040701001361 |
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