Provider Demographics
NPI:1326581992
Name:KNAPP, CARYLL SPRAGUE (PHD)
Entity Type:Individual
Prefix:DR
First Name:CARYLL
Middle Name:SPRAGUE
Last Name:KNAPP
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:CALLY
Other - Middle Name:SPRAGUE
Other - Last Name:KNAPP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:PO BOX 1784
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59771-1784
Mailing Address - Country:US
Mailing Address - Phone:406-580-5278
Mailing Address - Fax:
Practice Address - Street 1:1351 STONERIDGE DR STE D
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-7079
Practice Address - Country:US
Practice Address - Phone:406-580-5278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1996103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist