Individual
MARY SANDOVAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
200 POLK ST, ANACONDA, MT 59711-9611
(406) 691-2075
Mailing address
200 POLK ST, ANACONDA, MT 59711-9611
(406) 691-2075
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
BBH-LCPC-LIC-53516
MT
101YP2500X
Professional Counselor
Primary
BBH-LCPC-LIC-53516
MT
Other
Enumeration date
06/09/2022
Last updated
01/15/2026
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