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Contact Information

CHERYL R BLANK, PhD
121 W KAGY BLVD
BOZEMAN, MT59715-6000
 Phone: 406-587-7468
 Fax: 406-587-4520
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychologist

103T00000X 62 Psychologist, Clinical
 

Addiction (Substance Use Disorder)

101YA0400X
Indicates primary specialty

NPI Profile & details for CHERYL R BLANK · (Female)

NPI # 1932221058
Status Active
Credentials PhD
Entity Individual
Enumeration date 04/06/2007
Last updated 01/03/2011 - About 15 years ago
Sole proprietor 1 Yes
Identifiers
  • MT License # 202
  • MT License # 457
  • MT Medicaid 0000490807
  • MT Other 51011 BLUE CROSS - MSU
  • MT Other 52820 BLUE CROSS - PRIVATE PRAC
  • MT Other 264349 NEW WEST
  • MT Other 86-1155463 TRI CARE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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