Individual
DR. WILLIAM D PATENAUDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
500 W BROADWAY ST, MISSOULA, MT 59802-4008
(406) 327-1670
(406) 329-5697
Mailing address
500 W BROADWAY ST, MISSOULA, MT 59802-4008
(406) 327-1670
(406) 329-5697
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY-PSY-LIC-315
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0491793
—
MT
01
—
051891
BLUE CROSS SHIELD
MT
Enumeration date
01/10/2007
Last updated
02/02/2021
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