Healthcare Provider Details

I. General information

NPI: 1992490676
Provider Name (Legal Business Name): MICHELLE BLAIR REINHARDT PHARMD, BCPP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE LYNN BLAIR PHARMD, BCPP

II. Dates (important events)

Enumeration Date: 04/07/2023
Last Update Date: 04/28/2023
Certification Date: 04/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4061 SNOWBERRY AVE
KALISPELL MT
59901-3740
US

IV. Provider business mailing address

96 N WEAVER ST
BELGRADE MT
59714-7005
US

V. Phone/Fax

Practice location:
  • Phone: 775-815-9857
  • Fax:
Mailing address:
  • Phone: 406-219-7233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License NumberPHA-PHA-LIC-12249
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: