Provider Demographics
NPI:1821145087
Name:HOOD DAYHUFF, MARILYN (LCPC)
Entity Type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:
Last Name:HOOD DAYHUFF
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:MS
Other - First Name:MIMI
Other - Middle Name:
Other - Last Name:HOOD DAYHUFF
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCPC
Mailing Address - Street 1:1704 W BABCOCK ST
Mailing Address - Street 2:SUITE G
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-4058
Mailing Address - Country:US
Mailing Address - Phone:406-587-7515
Mailing Address - Fax:
Practice Address - Street 1:1704 W BABCOCK ST
Practice Address - Street 2:SUITE G
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-4058
Practice Address - Country:US
Practice Address - Phone:406-587-7515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT394101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT250410Medicaid
MT74423OtherBCBS PROVIDER #
MT394OtherLCPC LICENSE #