Provider Demographics
NPI:1487942348
Name:HAUER, JAMIE LEI (MFT)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:LEI
Last Name:HAUER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 32ND AVE NE
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59404-1233
Mailing Address - Country:US
Mailing Address - Phone:406-788-9702
Mailing Address - Fax:
Practice Address - Street 1:600 CENTRAL AVE STE 321
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59401-3157
Practice Address - Country:US
Practice Address - Phone:406-788-9702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-13
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT10657101YP2500X
MT140106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist