River, Vincent Bryan
River, Vincent Bryan is an sole proprietor health care provider with primary practice located at 1201 Main St Suite A, Polson MT 59860-5333. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Behavioral Health & Social Service Providers / Forensic. Behavioral Health & Social Service Providers / Clinical Child & Adolescent is his primary health care specialty. River, Vincent Bryan can be contacted via phone (406) 883-8126.Contact Information
Primary practice address
1201 Main St Suite A
Polson MT 59860-5333
Phone: (406) 883-8126
Fax: (406) 883-9226
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical Child & Adolescent | 103TC2200X | 328 | Montana |
| Behavioral Health & Social Service Providers / Forensic | 103TF0200X | 328 | Montana |
Profile Details
| NPI number | 1497821672 |
|---|---|
| LBN Legal business name | River, Vincent Bryan |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 28th, 2006 |
| Last updated | Oct 31st, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1497821672 | NPPES |
| Montana | MEDICAID | 490739 | |
| Montana | Other | 51871 | |
| Montana | Other | 7718 59860 0000 |
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