Healthcare Provider Details

I. General information

NPI: 1962076356
Provider Name (Legal Business Name): SHELBY LAGALY HAD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2021
Last Update Date: 10/25/2023
Certification Date: 10/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3039 GRAND AVE STE A
BILLINGS MT
59102-8124
US

IV. Provider business mailing address

1639 STONY MEADOW LN
BILLINGS MT
59101-8914
US

V. Phone/Fax

Practice location:
  • Phone: 406-252-4731
  • Fax:
Mailing address:
  • Phone: 406-861-9155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHAD-HAD-LIC-1649
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: