Individual
MRS. MARILYN KAE MATHERN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC, LAC
Contact information
Practice address
1601 2ND AVE N, STE. 622, GREAT FALLS, MT 59401-3259
(406) 781-4457
(406) 452-9040
Mailing address
1601 2ND AVE N, STE. 622, GREAT FALLS, MT 59401-3259
(406) 781-4457
(406) 452-9040
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1267LAC
MT
101YP2500X
Professional Counselor
Primary
1458LCPC
MT
Other
Enumeration date
12/31/2009
Last updated
06/16/2010
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