PAUL BACH PHD
Clinical Neuropsychologist
Missoula, Montana
Provider NPI: 1649227059
Provider Information:PAUL BACH PHD
Gender: M
Not Sole Proprietor
Practice Location:
900 N ORANGE ST THIRD FLOOR MISSOULA, MT 59802 US
Tel: 406-327-3350 Fax: 406-327-3396
Business Mailing Address:
87 SCHOOLHOUSE RD BLOOMSBURG, PA 17815 US
Tel: 570-317-2694 Fax: --
Entity Type: Individual
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 103G00000X | Behavioral Health & Social Service Providers Clinical Neuropsychologist | MT | 136 |
Y | 103TC0700X | Behavioral Health & Social Service Providers Psychologist | PA | PS016937 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
0490569 | MT | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin