Healthcare Provider Details
I. General information
NPI: 1477604882
Provider Name (Legal Business Name): BRENDA KAY ROCHE PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/13/2007
Last Update Date: 04/18/2025
Certification Date: 04/18/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1523 WYOMING AVE
BILLINGS MT
59102-4105
US
IV. Provider business mailing address
PO BOX 21359
BILLINGS MT
59104-1359
US
V. Phone/Fax
- Phone: 406-272-4990
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103G00000X |
| Taxonomy | Clinical Neuropsychologist |
| License Number | 420 |
| License Number State | WY |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103G00000X |
| Taxonomy | Clinical Neuropsychologist |
| License Number | 7182 |
| License Number State | MN |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | 357 |
| License Number State | MT |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | 420 |
| License Number State | WY |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Psychologist |
| License Number | 357 |
| License Number State | MT |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Psychologist |
| License Number | 420 |
| License Number State | WY |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | 357 |
| License Number State | MT |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | 420 |
| License Number State | WY |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC2200X |
| Taxonomy | Clinical Child & Adolescent Psychologist |
| License Number | 357 |
| License Number State | MT |
| # 10 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC2200X |
| Taxonomy | Clinical Child & Adolescent Psychologist |
| License Number | 420 |
| License Number State | WY |
| # 11 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TF0000X |
| Taxonomy | Family Psychologist |
| License Number | 357 |
| License Number State | MT |
| # 12 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TF0000X |
| Taxonomy | Family Psychologist |
| License Number | 420 |
| License Number State | WY |
| # 13 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TP2701X |
| Taxonomy | Group Psychotherapy Psychologist |
| License Number | 357 |
| License Number State | MT |
| # 14 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TP2701X |
| Taxonomy | Group Psychotherapy Psychologist |
| License Number | 420 |
| License Number State | WY |
| # 15 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103G00000X |
| Taxonomy | Clinical Neuropsychologist |
| License Number | 357 |
| License Number State | MT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone:
