Healthcare Provider Details

I. General information

NPI: 1306106018
Provider Name (Legal Business Name): SKORDAL PSYCHIATRIC SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2012
Last Update Date: 06/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1125 MISSOULA AVE SUITE B
HELENA MT
59601-3830
US

IV. Provider business mailing address

1125 MISSOULA AVE SUITE B
HELENA MT
59601-3830
US

V. Phone/Fax

Practice location:
  • Phone: 406-202-2172
  • Fax: 406-442-1190
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN30828
License Number StateMT

VIII. Authorized Official

Name: AMY JO SKORDAL
Title or Position: OWNER/MANAGER
Credential: PMHNP
Phone: 406-202-2172