Provider Demographics
NPI:1457454886
Name:VERALDI, DONNA MARY (PHD)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:MARY
Last Name:VERALDI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N 27TH ST
Mailing Address - Street 2:STE 320
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-2054
Mailing Address - Country:US
Mailing Address - Phone:406-256-8004
Mailing Address - Fax:406-256-2108
Practice Address - Street 1:100 N 27TH ST
Practice Address - Street 2:STE 320
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-2054
Practice Address - Country:US
Practice Address - Phone:406-256-8004
Practice Address - Fax:406-256-2108
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT125103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT490477Medicaid
MT50681OtherBLUE CROSS BLUE SHIELD
MT50681OtherBLUE CROSS BLUE SHIELD