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General NPI Number Information
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NPI Number | 1386262046
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Entity Type | Individual
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Provider Name | SHANNON ST. ONGE SCALLY DNP
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Gender | Female
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Dates
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Enumeration Date | 07/09/2020
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Last Update Date | 10/23/2023
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Provider Practice Location Address
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Address Line | SCALLY PSYCHIATRIC MENTAL HEALTH 2431 RIVER ROAD
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City | MISSOULA
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State | MT
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Zip | 59804-1239
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Country | US
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Telephone | 406-360-5093
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Fax | 406-720-7944
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Provider Business Mailing Address
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Address Line | 2431 RIVER RD
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City | MISSOULA
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State | MT
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Zip | 59804-1239
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Country | US
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Telephone | 406-360-5093
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Fax | 406-720-7944
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 195702
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 27210
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License Number State | MT
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