Individual
DR. CORY BENJAMIN-DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
2307 STEPHENS AVE STE A, MISSOULA, MT 59801-7901
(406) 829-2725
Mailing address
20115 CONIFER DR, HUSON, MT 59846-9769
(406) 829-2725
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
256
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0491249
—
MT
01
—
51991
BLUE CROSS BLUE SHIELD
MT
Enumeration date
12/29/2006
Last updated
05/03/2024
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