Individual
DR. DIANA L. BJORGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
301 W SPRUCE ST, MISSOULA, MT 59802-4107
(406) 327-9697
(406) 273-7601
Mailing address
PO BOX 1328, FLORENCE, MT 59833-1328
(406) 273-7600
(406) 273-7601
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
307
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0490348
—
MT
01
—
51411
BCBS PROVIDER #
MT
01
—
P00099519
RAILROAD MEDICARE
MT
Enumeration date
12/15/2006
Last updated
12/18/2007
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