Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 134 | MT |
N | 103TC0700X | Clinical Psychologist | 134 | MT |
N | 103G00000X | Clinical Psychologist | 134 | MT |
N | 103TC0700X | Clinical Psychologist | 134 | MT |
N | 103TF0200X | Forensic Psychologist | 134 | MT |
N | 103TR0400X | Rehabilitation Psychologist | 134 | MT |
NPI | 1386793289 |
---|---|
Provider Name | Dr. Patricia Lee Webber |
First Address | Missoula, MT 59803-1341 |
Second Address | Missoula, MT 59803-1341 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0493012 | (05) | NE |
13-00395-9 | MT STATE WORKMAN'S COMP. (01) | MT |
50901 | BLUE CROSS BLUE SHIELD (01) | MT |
R10068 | (02) | MT |