Provider Demographics
NPI:1629127063
Name:FIORE, CHRISTINE (PHD)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:FIORE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 N HIGGINS AVE
Mailing Address - Street 2:SUITE 324
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-4462
Mailing Address - Country:US
Mailing Address - Phone:406-243-2081
Mailing Address - Fax:
Practice Address - Street 1:1444 MANSFIELD AVE
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59812-0001
Practice Address - Country:US
Practice Address - Phone:406-243-2081
Practice Address - Fax:406-542-8950
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT253103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000050651OtherBCBS
MT0490790Medicaid
MT0490790Medicaid