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General NPI Number Information
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NPI Number | 1376766410
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Entity Type | Individual
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Provider Name | MARTHA S SILVERMAN PH.D.
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Gender | Female
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 634 EDDY AVE
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City | MISSOULA
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State | MT
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Zip | 59812-1851
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Country | US
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Telephone | 406-243-2274
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Fax |
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Provider Business Mailing Address
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Address Line | 2509 KLONDIKE CT
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City | MISSOULA
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State | MT
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Zip | 59808-9066
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Country | US
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Telephone | 406-243-2274
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 194
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License Number State | MT
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