Provider Demographics
NPI:1619792637
Name:MCNAMARA, ROSE M (SWLC)
Entity type:Individual
Prefix:
First Name:ROSE
Middle Name:M
Last Name:MCNAMARA
Suffix:
Gender:F
Credentials:SWLC
Other - Prefix:
Other - First Name:ROSE
Other - Middle Name:MARIE
Other - Last Name:LAPOLLA-SAAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1530
Mailing Address - Street 2:
Mailing Address - City:MILES CITY
Mailing Address - State:MT
Mailing Address - Zip Code:59301-1530
Mailing Address - Country:US
Mailing Address - Phone:406-234-0234
Mailing Address - Fax:
Practice Address - Street 1:2016 N MERRILL AVE
Practice Address - Street 2:
Practice Address - City:GLENDIVE
Practice Address - State:MT
Practice Address - Zip Code:59330-2062
Practice Address - Country:US
Practice Address - Phone:406-377-6075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-15
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT64428101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health