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General NPI Number Information
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NPI Number | 1902620115
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Entity Type | Organization
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Legal Business Name | DR. JOHN J SIEFKE PSYCHOLOGICAL SERVICES PLLC
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Dates
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Enumeration Date | 11/13/2024
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 1902 W DICKERSON ST STE 208
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City | BOZEMAN
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State | MT
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Zip | 59718-6852
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Country | US
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Telephone | 406-295-6899
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Fax |
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Provider Business Mailing Address
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Address Line | 1902 W DICKERSON ST STE 208
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City | BOZEMAN
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State | MT
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Zip | 59718-6852
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. JOHN SIEFKE
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Credential | PH.D.
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Telephone | 406-295-6899
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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 |
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License Number State |
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