Provider Demographics
NPI:1699259762
Name:DUCHARME, ZELMA MARIE
Entity type:Individual
Prefix:
First Name:ZELMA
Middle Name:MARIE
Last Name:DUCHARME
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 450
Mailing Address - Street 2:
Mailing Address - City:BROWNING
Mailing Address - State:MT
Mailing Address - Zip Code:59417-1289
Mailing Address - Country:US
Mailing Address - Phone:406-338-6330
Mailing Address - Fax:406-338-7660
Practice Address - Street 1:807 PIEGAN STREET
Practice Address - Street 2:
Practice Address - City:BROWNING
Practice Address - State:MT
Practice Address - Zip Code:59417-0450
Practice Address - Country:US
Practice Address - Phone:406-338-3948
Practice Address - Fax:406-338-2491
Is Sole Proprietor?:No
Enumeration Date:2018-09-24
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1332101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)