| Hallie Bornstein Banziger Phd Llc | |
|
125 Bank St Suite 310 Missoula MT 59802-4407 | |
| (406) 549-7325 | |
| Not Available |
| Full Name | Hallie Bornstein Banziger Phd Llc |
|---|---|
| Speciality | Psychologist |
| Location | 125 Bank St, Missoula, Montana |
| Authorized Official Name and Position | Hallie Alyssa Bornstein Banziger (OWNER) |
| Authorized Official Contact | 4062193311 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hallie Bornstein Banziger Phd Llc 935 Highland Blvd Suite 4400 Bozeman MT 59715-6904 Ph: (406) 219-3311 | Hallie Bornstein Banziger Phd Llc 125 Bank St Suite 310 Missoula MT 59802-4407 Ph: (406) 549-7325 |
| NPI Number | 1801062096 |
|---|---|
| Provider Enumeration Date | 05/07/2008 |
| Last Update Date | 10/22/2008 |
| Medicare PECOS PAC ID | 1951469253 |
|---|---|
| Medicare Enrollment ID | O20081015000013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801062096 | NPI | - | NPPES |
| 52501 | Other | MT | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 366 (Montana) | Primary |
| Provider Name | Hallie A Bornstein Banziger |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1326197906 PECOS PAC ID: 2163450180 Enrollment ID: I20050801000765 |
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