Individual
PAUL BACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
900 N ORANGE ST, THIRD FLOOR, MISSOULA, MT 59802-2998
(406) 327-3350
(406) 327-3396
Mailing address
87 SCHOOLHOUSE RD, BLOOMSBURG, PA 17815-9569
(570) 317-2694
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
136
MT
103TC0700X
Clinical Psychologist
Primary
PS016937
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0490569
—
MT
Enumeration date
05/30/2006
Last updated
01/23/2018
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