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General NPI Number Information
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NPI Number | 1386359016
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Entity Type | Organization
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Legal Business Name | BIG SKY PSYCHOLOGICAL COACHING LLC
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Dates
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Enumeration Date | 01/17/2023
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Last Update Date | 01/17/2023
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Provider Practice Location Address
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Address Line | 1643 24TH ST W STE 103
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City | BILLINGS
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State | MT
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Zip | 59102-2677
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Country | US
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Telephone | 406-662-8802
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Fax |
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Provider Business Mailing Address
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Address Line | 4315 PALISADES PARK DR
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City | BILLINGS
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State | MT
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Zip | 59106-1344
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Country | US
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Telephone | 540-287-6161
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DANIEL SCOTT WIEGERT
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Credential | PHD
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Telephone | 406-662-8802
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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