Doctor Name: | DR. JANET P. WOLLERSHEIM |
NPI Number: | 1013110113 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | 19 |
Business Practice Address: | 1900 Brooks St Missoula, MT - 598016644 |
Business Phone Number: | 4062744714 |
Business Fax Number: | |
Mailing Address: | 2625b Tanbark Way, MISSOULA |
State: | MT |
Postal Code: | 598085418 |
Phone Number: | 4062744714 |
Fax Number: | |
NPI Enumeration Date: | 06/06/2007 |
NPI Last Update Date: | 09/24/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 19 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |