Individual
MRS. MARY L THIELBAHR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MFT
Contact information
Practice address
20 BEARFOOT LANE, HERON, MT 59844
(406) 847-5850
(406) 847-4242
Mailing address
785 KANIKSU SHORES, SANDPOINT, ID 83864-6462
(208) 263-5894
(208) 263-8294
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
LEDPSY901
CA
106H00000X
Marriage & Family Therapist
Primary
18097
CA
106H00000X
Marriage & Family Therapist
LMFT2624
ID
Other
Enumeration date
06/19/2007
Last updated
12/03/2012
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