Individual
MARTHA FAIRCHILD DUDLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
612 E MAIN ST, SUITE B, BOZEMAN, MT 59715-3719
(406) 539-0300
(406) 522-0286
Mailing address
612 E MAIN ST, SUITE B, BOZEMAN, MT 59715-3719
(406) 539-0300
(406) 522-0286
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1037
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0255102
—
MT
Enumeration date
03/17/2007
Last updated
07/08/2007
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