Individual provider · Type 1 NPI

Marissa Mae Ilac, LCPC

Mental Health Counselor · Polson, MT

NPI number 1497339493 Active

Practice location

402 1st St. E. #205
Polson, MT 59860

Call (406) 260-1716 Map

Mailing address

PO Box 731
Hot Springs, MT 59845-0731

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XBBH-LCPC-LIC-48659 (MT)

Mental Health Counselor: Definition to come...

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About NPI 1497339493

Marissa Mae Ilac, LCPC's National Provider Identifier is 1497339493, issued on May 6, 2021. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Polson, MT. The record was last updated on May 6, 2021.