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General NPI Number Information
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NPI Number | 1306106018
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Entity Type | Organization
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Legal Business Name | SKORDAL PSYCHIATRIC SERVICES, PLLC
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Dates
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Enumeration Date | 05/29/2012
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Last Update Date | 06/06/2012
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Provider Practice Location Address
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Address Line | 1125 MISSOULA AVE SUITE B
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City | HELENA
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State | MT
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Zip | 59601-3830
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Country | US
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Telephone | 406-202-2172
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Fax | 406-442-1190
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Provider Business Mailing Address
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Address Line | 1125 MISSOULA AVE SUITE B
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City | HELENA
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State | MT
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Zip | 59601-3830
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | AMY JO SKORDAL
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Credential | PMHNP
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Telephone | 406-202-2172
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN30828
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License Number State | MT
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