Provider Demographics
NPI:1487726733
Name:WOOLSTON, WILLIAM DEE (PHD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:DEE
Last Name:WOOLSTON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 GRAND AVE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-4213
Mailing Address - Country:US
Mailing Address - Phone:406-655-4904
Mailing Address - Fax:406-655-2386
Practice Address - Street 1:1211 GRAND AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-4213
Practice Address - Country:US
Practice Address - Phone:406-655-4904
Practice Address - Fax:406-655-2386
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT81103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0490581Medicaid
MT05176-0OtherBLUE CROSS BLUE SHIELD