Individual
DR. VINCENT BRYAN RIVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1201 MAIN ST, SUITE A, POLSON, MT 59860-5333
(406) 883-8126
(406) 883-9226
Mailing address
1201 MAIN ST, SUITE A, POLSON, MT 59860-5333
(406) 883-8126
(406) 883-9226
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
328
MT
103TF0200X
Forensic Psychologist
328
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
490739
—
MT
01
—
51871
BLUE CROSS BLUE SHIELD
MT
01
—
7718 59860 0000
TRICARE
MT
Enumeration date
11/28/2006
Last updated
10/31/2012
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