Individual
MARY JANE FOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
240 ZIMMERMAN RD, KALISPELL, MT 59901-4653
(406) 250-6375
Mailing address
PO BOX 1301, KALISPELL, MT 59903-1301
(406) 250-6375
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
228
MT
Other
Enumeration date
11/12/2006
Last updated
07/08/2007
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