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Individual

MRS. MARY KATHRYN FAHLGREN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCPC

Contact information

Practice address
316 1ST ALY N, GLASGOW, MT 59230-1817
(406) 228-8686
Mailing address
625 4TH AVE N, GLASGOW, MT 59230-1729
(406) 228-8922

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1160
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0000256530
MT
Enumeration date
11/08/2006
Last updated
07/09/2007
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