Organization
SPARK NEUROBEHAVIORAL SOLUTIONS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEE PERRY (MANAGING PARTNER)
(406) 624-3632
Entity
Organization
Contact information
Practice address
407 W MAIN ST, BOZEMAN, MT 59715-4578
(406) 624-3632
Mailing address
1707 S ROUSE AVE, BOZEMAN, MT 59715-5758
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
—
—
Other
Enumeration date
04/06/2018
Last updated
04/06/2018
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