| NPI | 1184452138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON S SCALLY Owner/Provider 406-361-5093 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-07-22 |
| Last Update Date | 2024-09-05 |