| NPI | 1811048226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA KAY ROCHE Manager And Neuropsychologist 406-294-9510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MT 1137) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: MT 511) |
| 101YP2500X Counselor Professional (Licence: WY 840) | |
| 103G00000X Clinical Neuropsychologist (Licence: MT 357) | |
| 103G00000X Clinical Neuropsychologist (Licence: WY 420) | |
| 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: MT 357) | |
| 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: WY 420) | |
| 103TC0700X Psychologist Clinical (Licence: MT 357) | |
| 103TC0700X Psychologist Clinical (Licence: WY 420) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: MT 357) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: WY 420) | |
| 103TF0000X Psychologist Family (Licence: MT 357) | |
| 103TF0000X Psychologist Family (Licence: WY 420) | |
| 103T00000X Psychologist (Licence: MT 357) | |
| 103TP2701X Psychologist Group Psychotherapy (Licence: MT 357) | |
| Enumeration Date | 2007-01-13 |
| Last Update Date | 2020-08-22 |