Provider Demographics
NPI:1588678346
Name:KRONSKE, REBECCA LYNN (MS)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:LYNN
Last Name:KRONSKE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2508 VALHALLA CT
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-1502
Mailing Address - Country:US
Mailing Address - Phone:406-600-0763
Mailing Address - Fax:
Practice Address - Street 1:205 HAGGERTY LN
Practice Address - Street 2:STE 255
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-8800
Practice Address - Country:US
Practice Address - Phone:406-600-0763
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2009-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000744813OtherBCBS PRE-LICENSED
MT255374Medicaid