Individual
CODY PENDERGRASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
931 HIGHLAND BLVD STE 3210, BOZEMAN, MT 59715-6912
(406) 414-5000
Mailing address
915 HIGHLAND BLVD, BOZEMAN, MT 59715-6902
(406) 414-5000
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PSY-PSY-LIC-3633
MT
103G00000X
Clinical Neuropsychologist
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Other
Enumeration date
03/09/2015
Last updated
04/09/2025
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