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General NPI Number Information
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NPI Number | 1194098046
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Entity Type | Individual
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Provider Name | MARGOT LUCKMAN CRC, LCPC
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Gender | Female
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Dates
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Enumeration Date | 02/22/2012
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Last Update Date | 02/22/2012
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Provider Practice Location Address
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Address Line | 2305 DUNCAN DR
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City | MISSOULA
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State | MT
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Zip | 59802-3455
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Country | US
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Telephone | 406-542-0820
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Fax | 406-542-0843
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Provider Business Mailing Address
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Address Line | 2305 DUNCAN DRIVE
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City | MISSOULA
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State | MT
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Zip | 59802
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Country | US
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Telephone | 406-542-0820
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Fax | 406-542-0843
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 277
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License Number State | MT
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