Provider Demographics
NPI:1477088771
Name:TREECE, DEBORAH ELIZABETH (PC)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:ELIZABETH
Last Name:TREECE
Suffix:
Gender:F
Credentials:PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:670 PARK AVE
Mailing Address - Street 2:PO BOX 990
Mailing Address - City:SHELBY
Mailing Address - State:MT
Mailing Address - Zip Code:59474-1663
Mailing Address - Country:US
Mailing Address - Phone:406-434-3110
Mailing Address - Fax:406-434-3143
Practice Address - Street 1:670 PARK AVE
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:MT
Practice Address - Zip Code:59474-1663
Practice Address - Country:US
Practice Address - Phone:406-434-3110
Practice Address - Fax:406-434-3143
Is Sole Proprietor?:No
Enumeration Date:2017-04-24
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT23923101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT23923OtherMT BBH PCLC LICENSE