Provider Demographics
NPI:1871831164
Name:DUDA, CHRISTINE KAY (BBH-PCLC-LIC)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:KAY
Last Name:DUDA
Suffix:
Gender:F
Credentials:BBH-PCLC-LIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 81241
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59108-1241
Mailing Address - Country:US
Mailing Address - Phone:402-649-7958
Mailing Address - Fax:
Practice Address - Street 1:1750 RAY OF HOPE LN
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59106
Practice Address - Country:US
Practice Address - Phone:406-656-2198
Practice Address - Fax:406-651-2802
Is Sole Proprietor?:No
Enumeration Date:2013-01-22
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE9863101YM0800X
MT38687101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025173100Medicaid