Healthcare Provider Details

I. General information

NPI: 1871497669
Provider Name (Legal Business Name): KARI LIANNE NEAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4210 S RESERVE ST
MISSOULA MT
59803-1035
US

IV. Provider business mailing address

1401 CEDAR ST UNIT 24
MISSOULA MT
59802-3919
US

V. Phone/Fax

Practice location:
  • Phone: 406-542-4045
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberBBH-PCLC-LIC-90734
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: