Provider Demographics
NPI:1558107805
Name:HALL, MARIAH (IHP2, FMCHC, RMA)
Entity type:Individual
Prefix:
First Name:MARIAH
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:IHP2, FMCHC, RMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3104 7TH AVE N
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59401-2119
Mailing Address - Country:US
Mailing Address - Phone:406-231-1904
Mailing Address - Fax:
Practice Address - Street 1:3104 7TH AVE N
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59401-2119
Practice Address - Country:US
Practice Address - Phone:406-231-1904
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-06
Last Update Date:2024-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach