Lara Mattson Radle, L.C.P.C

NPI 1629306287 · on the registry since 2009 · sole proprietor

Practice

Address: 1515 E Broadway St
Missoula, MT 59802
Phone: (406) 728-2662
Fax: (406) 728-2879
Organisation at this address: Friends To Youth Inc.
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 2

Registry record

Primary taxonomy: 101YP2500X
101YP2500X
Licence states on file: MT
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2009-11-19

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Montana