| Doctor Name: | DR. VINCENT BRYAN RIVER |
| NPI Number: | 1497821672 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | 328 |
| Business Practice Address: | 1201 Main St Suite A Polson, MT - 598605333 |
| Business Phone Number: | 4068838126 |
| Business Fax Number: | 4068839226 |
| Mailing Address: | 1201 Main St, Suite A POLSON |
| State: | MT |
| Postal Code: | 598605333 |
| Phone Number: | 4068838126 |
| Fax Number: | 4068839226 |
| NPI Enumeration Date: | 11/28/2006 |
| NPI Last Update Date: | 10/31/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TF0200X |
| License Number: | 328 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Forensic |
| Taxonomy Definition: | |