Healthcare Provider Details

I. General information

NPI: 1447809488
Provider Name (Legal Business Name): MARILYN RHODES L.A.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2019
Last Update Date: 11/27/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 NORTH PIEGAN STREET
BROWNING MT
59417
US

IV. Provider business mailing address

PO BOX 450
BROWNING MT
59417-0450
US

V. Phone/Fax

Practice location:
  • Phone: 406-338-6330
  • Fax:
Mailing address:
  • Phone: 406-338-6330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number3426
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: