Provider Demographics
NPI:1851055941
Name:MONTANA STATE UNIVERSITY BILLINGS
Entity Type:Organization
Organization Name:MONTANA STATE UNIVERSITY BILLINGS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KRYSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUSSAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MS BCBA
Authorized Official - Phone:406-657-2354
Mailing Address - Street 1:1500 UNIVERSITY DRIVE
Mailing Address - Street 2:MSUB/COE/MCIE #174
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-0245
Mailing Address - Country:US
Mailing Address - Phone:406-657-2323
Mailing Address - Fax:406-657-2313
Practice Address - Street 1:1500 UNIVERSITY DRIVE
Practice Address - Street 2:MSUB/COE/MCIE #174
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-0245
Practice Address - Country:US
Practice Address - Phone:406-657-2323
Practice Address - Fax:406-657-2313
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MONTANA STATE UNIVERSITY BILLINGS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0008XAllopathic & Osteopathic PhysiciansPediatricsNeurodevelopmental DisabilitiesGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty