Organization
GALLATIN PSYCHOTHERAPY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN D WIMBERLY PHD (THERAPIST)
(406) 582-0500
Entity
Organization
Contact information
Practice address
1902 W DICKERSON ST STE 208, BOZEMAN, MT 59718-6852
(406) 582-0500
Mailing address
1902 W DICKERSON ST STE 208, BOZEMAN, MT 59718-6852
(406) 582-0500
Taxonomy
Speciality
Code
Description
License number
State
103TP2701X
Group Psychotherapy Psychologist
Primary
318
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0490688
—
MT
01
—
051821
BCBS
MT
Enumeration date
10/02/2008
Last updated
10/02/2008
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