Provider Demographics
NPI:1497266084
Name:BIG SKY THERAPY ASSOCIATES, PLLP
Entity Type:Organization
Organization Name:BIG SKY THERAPY ASSOCIATES, PLLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SPEECH- LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MATTINGLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:406-730-3454
Mailing Address - Street 1:PO BOX 404
Mailing Address - Street 2:
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937-0404
Mailing Address - Country:US
Mailing Address - Phone:406-730-3454
Mailing Address - Fax:855-312-7680
Practice Address - Street 1:100 2ND ST E STE 322
Practice Address - Street 2:
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937-2410
Practice Address - Country:US
Practice Address - Phone:406-730-3454
Practice Address - Fax:855-312-7680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-23
Last Update Date:2017-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2208103TC2200X
MTSLP-SP-LIC-1221235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty