| Doctor Name: | FRANK VONBANNISSEHT |
| NPI Number: | 1194043869 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LAC |
| License Number: | 1328 |
| Business Practice Address: | 2508 Wilson St Miles City, MT - 593015000 |
| Business Phone Number: | 4062340234 |
| Business Fax Number: | 4062340235 |
| Mailing Address: | 2508 Wilson St, MILES CITY |
| State: | MT |
| Postal Code: | 593015000 |
| Phone Number: | 4062340234 |
| Fax Number: | 4062340235 |
| NPI Enumeration Date: | 05/05/2010 |
| NPI Last Update Date: | 05/05/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 1328 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |