Organization
WILLIAM L. SUDA, PH.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM LEROY SUDA PH.D. (PRESIDENT)
(406) 363-2266
Entity
Organization
Contact information
Practice address
1201 WESTWOOD DR, SUITE C, HAMILTON, MT 59840-2305
(406) 363-2266
(406) 363-2266
Mailing address
1201 WESTWOOD DR, SUITE C, HAMILTON, MT 59840-2305
(406) 363-2266
(406) 363-2266
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
89
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
163709
MENTAL HEALTH NETWORK
MT
05
—
49-1244
—
MT
01
—
51550
BLUE CROSS OF MONTANA
MT
Enumeration date
08/08/2007
Last updated
08/08/2007
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