Individual
JOHN ROBERT HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
601 W SPRUCE ST STE K, MISSOULA, MT 59802-4047
(406) 327-3330
(406) 327-2399
Mailing address
PO BOX 31001-4110, PASADENA, CA 91110-4110
(406) 327-3330
(406) 327-2399
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PSY-PSY-LIC-226
MT
103T00000X
Psychologist
PSY-PSY-LIC-226
MT
103TS0200X
School Psychologist
59040
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000052321
BCBS PROVIDER NUMBER
MT
05
—
0492524
—
MT
Enumeration date
07/13/2006
Last updated
04/20/2025
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