Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 1033 | MT |
N | 101YP2500X | Professional Counselor | 1033 | MT |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 1033 | MT |
NPI | 1053435149 |
---|---|
Provider Name | Mrs. Amy E Rue |
First Address | Bozeman, MT 59718-9759 |
Second Address | Bozeman, MT 59715-5810 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2007 |
Last Update Date | 14/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
742180 | BCBSMT PROVIDER ID (01) | MT |