Individual
DR. LARUE R MONTANYE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.ED.
Contact information
Practice address
355 BROAD ST, MONTOURSVILLE, PA 17754-2221
(570) 368-2624
(570) 368-2212
Mailing address
355 BROAD ST, P.O. BOX 125, MONTOURSVILLE, PA 17754-2221
(570) 368-2624
(570) 368-2212
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS002406L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
078268
FPH
PA
01
—
376851
BLUE CROSS
PA
Enumeration date
12/18/2006
Last updated
07/08/2007
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