Provider Demographics
NPI:1154640191
Name:SUSAN DAY PHD LLC
Entity Type:Organization
Organization Name:SUSAN DAY PHD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:DAY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:406-327-9992
Mailing Address - Street 1:119 W FRONT ST
Mailing Address - Street 2:STE 309
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-4011
Mailing Address - Country:US
Mailing Address - Phone:406-327-9992
Mailing Address - Fax:406-327-9987
Practice Address - Street 1:119 W FRONT ST
Practice Address - Street 2:STE 309
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4011
Practice Address - Country:US
Practice Address - Phone:406-327-9992
Practice Address - Fax:406-327-9987
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-28
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT347103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty