Individual
MRS. MARY LOUISE DEROCHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.A.C.
Contact information
Practice address
807 NORTH PIEGAN STREET, BROWNING, MT 59417
(406) 338-6330
Mailing address
PO BOX 450, BROWNING, MT 59417-0450
(406) 338-6330
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
786
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285854885
—
MT
Enumeration date
09/03/2019
Last updated
11/27/2023
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