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General NPI Number Information
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NPI Number | 1235565094
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Entity Type | Organization
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Legal Business Name | MARK ROTHMAN COUNSELING LLC
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Dates
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Enumeration Date | 09/24/2013
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Last Update Date | 09/24/2013
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Provider Practice Location Address
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Address Line | 336 W SPRUCE ST
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City | MISSOULA
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State | MT
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Zip | 59802-4108
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Country | US
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Telephone | 406-529-2439
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Fax | 406-721-2833
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Provider Business Mailing Address
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Address Line | 601 CHERRY ST
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City | MISSOULA
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State | MT
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Zip | 59802-3705
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Country | US
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Telephone | 406-529-1610
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Fax |
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Authorized Official
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Title or Position | LCPC
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Name | MARK ERIC ROTHMAN
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Credential | M.A.
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Telephone | 406-529-2439
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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 | 1141
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License Number State | MT
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