Dudley, Martha Fairchild
Dudley, Martha Fairchild is an sole proprietor health care provider with primary practice located at 612 E Main St Suite B, Bozeman MT 59715-3719. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Dudley, Martha Fairchild can be contacted via phone (406) 539-0300.Contact Information
Primary practice address
612 E Main St Suite B
Bozeman MT 59715-3719
Phone: (406) 539-0300
Fax: (406) 522-0286
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 1037 | Montana |
Profile Details
| NPI number | 1366566358 |
|---|---|
| LBN Legal business name | Dudley, Martha Fairchild |
| Credentials | LCPC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 17th, 2007 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366566358 | NPPES |
| Montana | MEDICAID | 0255102 |
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