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Individual

MIRA LUTZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
400 15TH AVE S STE 205, GREAT FALLS, MT 59405-4375
(406) 455-2760
Mailing address
PO BOX 6010, GREAT FALLS, MT 59406-6010

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
0001533
CO
106H00000X
Marriage & Family Therapist
074101
IA
106H00000X
Marriage & Family Therapist
Primary
74556
MT

Other

Enumeration date
08/14/2014
Last updated
07/17/2025
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