Provider Demographics
NPI:1114313137
Name:RAIHA-RAUCH, MELANIE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:
Last Name:RAIHA-RAUCH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:MARIE
Other - Last Name:RAUCH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:2695 STRATFORD LN
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59808-5878
Mailing Address - Country:US
Mailing Address - Phone:406-370-9497
Mailing Address - Fax:
Practice Address - Street 1:2695 STRATFORD LN
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59808-5878
Practice Address - Country:US
Practice Address - Phone:406-370-9497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-07
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT117301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical