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NPI Code Detail

MEDICARE: ANGELIA MARIE DISALVO

MEDICARE:   ANGELIA MARIE DISALVO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor11059MT

General Provider Information

NPI Number : 1194111278
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELIA MARIE DISALVO
Provider Business Mailing Address
First Line : 1601 2ND AVE N STE 450A
Second Line :
City : GREAT FALLS
State : MT
Zip : 59401-3259
Country : US
Telephone Number : 406-395-4486
Fax Number : 406-395-4138
Provider Business Practice Location Address
First Line : 1601 2ND AVE N STE 450A
Second Line :
City : GREAT FALLS
State : MT
Zip : 59401-3259
Country : US
Telephone Number : 406-800-5874
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2015
Last Update Date : 01/17/2026

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Directions to “ ANGELIA MARIE DISALVO ” Practice Location

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