Healthcare Provider Details

I. General information

NPI: 1356871503
Provider Name (Legal Business Name): MARGARET MARY GIRARDI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2017
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 N ORANGE ST STE 102
MISSOULA MT
59802-2951
US

IV. Provider business mailing address

500 W BROADWAY ST
MISSOULA MT
59802-4008
US

V. Phone/Fax

Practice location:
  • Phone: 406-327-3034
  • Fax:
Mailing address:
  • Phone: 406-327-1918
  • Fax: 406-549-2246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number24463
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: