Individual
JAMES LEE WAHLBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
2831 FORT MISSOULA ROAD, SUITE 201, MISSOULA, MT 59804-7401
(406) 728-8818
(406) 327-4552
Mailing address
2831 FORT MISSOULA ROAD, SUITE 201, MISSOULA, MT 59804-7401
(406) 728-8818
(406) 327-4552
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
109
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
492596
—
MT
01
—
51670
BCBS
MT
Enumeration date
11/01/2006
Last updated
07/08/2007
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