Provider Demographics
NPI:1871959031
Name:PAGE, ROBERT (EDD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:PAGE
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 RIVER DR
Mailing Address - Street 2:
Mailing Address - City:CASCADE
Mailing Address - State:MT
Mailing Address - Zip Code:59421-8407
Mailing Address - Country:US
Mailing Address - Phone:406-449-3333
Mailing Address - Fax:
Practice Address - Street 1:26 RIVER DR
Practice Address - Street 2:
Practice Address - City:CASCADE
Practice Address - State:MT
Practice Address - Zip Code:59421-8407
Practice Address - Country:US
Practice Address - Phone:406-449-3333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-04
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTMT457103TF0200X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic