Individual
DR. MICHELE CATHERINE MCKINNIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1648 ELLIS ST, SUITE 302, BOZEMAN, MT 59715-8810
(406) 582-1321
(406) 587-1513
Mailing address
1648 ELLIS ST, SUITE 302, BOZEMAN, MT 59715-8810
(406) 582-1321
(406) 587-1513
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
338
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000492881
—
MT
01
—
52441
BCBS-MT PROVIDER NUMBER
MT
Enumeration date
12/19/2006
Last updated
12/04/2007
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