Provider Demographics
NPI:1598254583
Name:LOECKER, ERIN MAILIE (RBT)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:MAILIE
Last Name:LOECKER
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 SMELTER AVE NE
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59404-1937
Mailing Address - Country:US
Mailing Address - Phone:406-453-5930
Mailing Address - Fax:406-453-5930
Practice Address - Street 1:215 SMELTER AVE NE
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59404-1937
Practice Address - Country:US
Practice Address - Phone:406-453-5930
Practice Address - Fax:406-453-5930
Is Sole Proprietor?:No
Enumeration Date:2018-05-04
Last Update Date:2018-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
RBT-18-53985OtherBACB - RBT CREDENTIAL