Healthcare Provider Details

I. General information

NPI: 1487769592
Provider Name (Legal Business Name): MARY MARGARET GARMAN LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARY WOOD GARMAN LCPC

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

417 BROADWAY ST CENTER FOR MENTAL HEALTH
TOWNSEND MT
59644-2323
US

IV. Provider business mailing address

PO BOX 1271
TOWNSEND MT
59644-1271
US

V. Phone/Fax

Practice location:
  • Phone: 406-266-3327
  • Fax: 406-266-4840
Mailing address:
  • Phone: 406-266-4867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number856 LCPC
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: