1679911168 NPI number — PAMELA GALE BING PERRY MBA, MS, DMFT, LMFT

Table of content: PAMELA GALE BING PERRY MBA, MS, DMFT, LMFT (NPI 1679911168)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679911168 NPI number — PAMELA GALE BING PERRY MBA, MS, DMFT, LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BING PERRY
Provider First Name:
PAMELA
Provider Middle Name:
GALE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MBA, MS, DMFT, LMFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1679911168
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/06/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 30053
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BILLINGS
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59107-0053
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
902 WYOMING AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BILLINGS
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59101-1637
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-850-9219
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/06/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  SWP-LMFT-LIC 58 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)