Provider Demographics
NPI:1730302142
Name:TORREZ, DARLA MARIE (LM CPM)
Entity Type:Individual
Prefix:MS
First Name:DARLA
Middle Name:MARIE
Last Name:TORREZ
Suffix:
Gender:F
Credentials:LM CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:732 GERALD AVE
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-2738
Mailing Address - Country:US
Mailing Address - Phone:406-728-6454
Mailing Address - Fax:
Practice Address - Street 1:732 GERALD AVE
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-2738
Practice Address - Country:US
Practice Address - Phone:406-880-6454
Practice Address - Fax:406-235-7073
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2014-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT28176B00000X, 176B00000X
174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No174N00000XOther Service ProvidersLactation Consultant, Non-RN
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT36181OtherBLUE CROSS BLUE SHIELD