Provider Demographics
NPI:1588212450
Name:FEE, RUXANDRA (LAC CANDIDATE)
Entity Type:Individual
Prefix:
First Name:RUXANDRA
Middle Name:
Last Name:FEE
Suffix:
Gender:F
Credentials:LAC CANDIDATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 5TH ST N STE 201
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59401-4011
Mailing Address - Country:US
Mailing Address - Phone:406-781-4414
Mailing Address - Fax:
Practice Address - Street 1:2 5TH ST N STE 201
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59401-4011
Practice Address - Country:US
Practice Address - Phone:406-781-4414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-03
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT38094101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)