Individual
MS. NADINE M. WISNIEWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
27 FORT MISSOULA RD, STE B4, MISSOULA, MT 59804-7206
(406) 370-1727
Mailing address
PO BOX 1171, FLORENCE, MT 59833-1171
(406) 370-1727
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
MT254
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50641
BLUE CROSS
MT
Enumeration date
03/24/2007
Last updated
01/14/2019
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