MEDICARE: DR. KIMBERLY RENEE HARKINS-SCHUELKE PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	216	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	50881	OTHER	MT	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1932241932
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIMBERLY RENEE HARKINS-SCHUELKE PH.D.

Provider Business Mailing Address
First Line	:	1018 BURLINGTON AVE
Second Line	:	STE 101B
City	:	MISSOULA
State	:	MT
Zip	:	59801-5666
Country	:	US
Telephone Number	:	406-549-7177
Fax Number	:

Provider Business Practice Location Address
First Line	:	1018 BURLINGTON AVE
Second Line	:	STE 101B
City	:	MISSOULA
State	:	MT
Zip	:	59801-5666
Country	:	US
Telephone Number	:	406-549-7177
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2007
Last Update Date	:	09/22/2017

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