Individual
MRS. MARILYN J IVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
410 CENTRAL AVE, SUITE 510, GREAT FALLS, MT 59401
(406) 453-3384
Mailing address
PO BOX 234, GREAT FALLS, MT 59403
(406) 453-3384
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
553
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
254150
—
MT
01
—
74915
BLUE CROSS BLUE SHIELD
MT
Enumeration date
04/19/2007
Last updated
07/08/2007
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