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General NPI Number Information
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NPI Number | 1063634327
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Entity Type | Organization
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Legal Business Name | ASPEN PRACTICE PC
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2810 CENTRAL AVE, SUITE A
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City | BILLINGS
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State | MT
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Zip | 59102-4651
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Country | US
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Telephone | 406-294-9677
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Fax |
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Provider Business Mailing Address
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Address Line | 2810 CENTRAL AVE, SUITE A
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City | BILLINGS
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State | MT
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Zip | 59102-4651
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Country | US
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Telephone | 406-294-9677
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Fax |
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Authorized Official
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Title or Position | CEO LICENSED PSYCHOLOGIST
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Name | DR. MICHAEL RAY BUTZ
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Credential | PH.D.
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Telephone | 406-294-9677
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 365
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License Number State | MT
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