Healthcare Provider Details

I. General information

NPI: 1790341998
Provider Name (Legal Business Name): LAURA LOPACH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2019
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1821 SOUTH AVE W STE 400
MISSOULA MT
59801-6521
US

IV. Provider business mailing address

1821 SOUTH AVE W STE 400
MISSOULA MT
59801-6521
US

V. Phone/Fax

Practice location:
  • Phone: 406-209-8905
  • Fax: 406-219-0740
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: LAURA C. LOPACH
Title or Position: OWNER
Credential:
Phone: 406-459-8532