Provider Demographics
NPI:1457165789
Name:MCDONALD, PAYTON ANNE
Entity type:Individual
Prefix:
First Name:PAYTON
Middle Name:ANNE
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2060 OVERLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-6439
Mailing Address - Country:US
Mailing Address - Phone:406-651-5700
Mailing Address - Fax:406-894-2004
Practice Address - Street 1:2060 OVERLAND AVE
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-6439
Practice Address - Country:US
Practice Address - Phone:406-651-5700
Practice Address - Fax:406-894-2004
Is Sole Proprietor?:No
Enumeration Date:2025-02-06
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTRBT-24-375734106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician