| Doctor Name: | MRS. MARY BARRON WOLDSTAD |
| NPI Number: | 1629091152 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A., L.C.P.C., C.M. |
| License Number: | 17659 |
| Business Practice Address: | 422 Montana Valier, MT - 59486 |
| Business Phone Number: | 4063383671 |
| Business Fax Number: | 4063383671 |
| Mailing Address: | P.o. Box 21, VALIER |
| State: | MT |
| Postal Code: | 594860021 |
| Phone Number: | 4063383671 |
| Fax Number: | 4063383671 |
| NPI Enumeration Date: | 07/25/2006 |
| NPI Last Update Date: | 11/25/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 17659 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |