Individual
DR. HALLIE A BORNSTEIN BANZIGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
125 BANK STREET, SUITE 310, MISSOULA, MT 59802
(406) 549-7325
(406) 549-7559
Mailing address
125 BANK STREET, SUITE 310, MISSOULA, MT 59802
(406) 549-7325
(406) 549-7559
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
MT366
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0492949
—
MT
01
—
52501
BLUE CROSS SHIELD
MT
Enumeration date
01/10/2007
Last updated
07/08/2007
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