Healthcare Provider Details

I. General information

NPI: 1871444638
Provider Name (Legal Business Name): TINA MARIE DEL POLITO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 2ND AVE N STE 700
GREAT FALLS MT
59401-3288
US

IV. Provider business mailing address

PO BOX 6451 SUITE 700
GREAT FALLS MT
59406-6451
US

V. Phone/Fax

Practice location:
  • Phone: 406-205-0452
  • Fax:
Mailing address:
  • Phone: 406-205-0452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: