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Individual

DR. WILLIAM LEROY SUDA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
1201 WESTWOOD DR, SUITE C, HAMILTON, MT 59840-2305
(406) 363-2266
(406) 363-2266
Mailing address
1201 WESTWOOD DR, SUITE C, HAMILTON, MT 59840-2305
(406) 363-2266
(406) 363-2266

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
89
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
163709
MENTAL HEALTH NETWORK
MT
05
49-1244
MT
01
51550
BLUE CROSS BLUE SHIELD
MT
Enumeration date
12/28/2006
Last updated
07/08/2007
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