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General NPI Number Information
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NPI Number | 1104791110
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Entity Type | Individual
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Provider Name | MEGHAN ELIZABETH INTERMILL
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Gender | Female
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Dates
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Enumeration Date | 10/08/2025
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | 1320 S 3RD ST W
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City | MISSOULA
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State | MT
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Zip | 59801-2332
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Country | US
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Telephone | 406-952-3772
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Fax |
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Provider Business Mailing Address
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Address Line | 825 SHERWOOD ST APT A
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City | MISSOULA
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State | MT
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Zip | 59802-2643
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Country | US
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Telephone | 703-261-5213
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | BBH-SWLC-LIC-81080
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License Number State | MT
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