JOHN ROBERT HARRISON PHD
Clinical Neuropsychologist
Missoula, Montana
Provider NPI: 1295750636
Provider Information:JOHN ROBERT HARRISON PHD
Gender: M
Not Sole Proprietor
Practice Location:
2825 FORT MISSOULA RD STE 301 MISSOULA, MT 59804 US
Tel: 406-327-4688 Fax: 406-327-4291
Business Mailing Address:
2825 FORT MISSOULA RD STE 301 MISSOULA, MT 59804 US
Tel: 406-327-4688 Fax: 406-327-4291
Entity Type: Individual
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 103G00000X | Behavioral Health & Social Service Providers Clinical Neuropsychologist | MT | 226 |
N | 103T00000X | Behavioral Health & Social Service Providers Psychologist | MT | PSY-PSY-LIC-226 |
N | 103TS0200X | Behavioral Health & Social Service Providers Psychologist | MT | 59040 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
0492524 | MT | 05 | |
BCBS PROVIDER NUMBER | 000052321 | MT | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin