Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 357 | MT |
Y | 103TC0700X | Clinical Psychologist | 357 | MT |
N | 103G00000X | Clinical Psychologist | 420 | WY |
N | 103TC0700X | Clinical Psychologist | 420 | WY |
N | 102L00000X | Psychologist | 357 | MT |
N | 103T00000X | Psychologist | 357 | MT |
N | 102L00000X | Psychologist | 420 | WY |
N | 103T00000X | Psychologist | 420 | WY |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 357 | MT |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 420 | WY |
N | 103G00000X | Clinical Psychologist | 357 | MT |
N | 103TC0700X | Clinical Psychologist | 357 | MT |
N | 103G00000X | Clinical Psychologist | 420 | WY |
N | 103TC0700X | Clinical Psychologist | 420 | WY |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 357 | MT |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 420 | WY |
N | 103TF0000X | Family Psychologist | 357 | MT |
N | 103TF0000X | Family Psychologist | 420 | WY |
N | 103TP2701X | Group Psychotherapist | 357 | MT |
N | 103TP2701X | Group Psychotherapist | 420 | WY |
NPI | 1477604882 |
---|---|
Provider Name | Dr. Brenda Kay Roche |
First Address | Billings, MT 59104-1359 |
Second Address | Billings, MT 59102-4105 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/01/2007 |
Last Update Date | 02/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0492405 | (05) | MT |
1206672 00 | WYOMING EQUALITY CARE (01) | WY |
180461042494 | PREFERRED ONE (01) | MT |
52431 | BLUE CROSS BLUE SHIELD (01) | MT |