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General NPI Number Information
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NPI Number | 1548077332
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Entity Type | Organization
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Legal Business Name | POPPY AND SAGE COUNSELING PLLC
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Dates
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Enumeration Date | 12/16/2024
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 2713 OSHAUGHNESY ST
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City | MISSOULA
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State | MT
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Zip | 59808-1329
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Country | US
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Telephone | 469-630-1615
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 18281
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City | MISSOULA
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State | MT
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Zip | 59808-8281
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Country | US
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Telephone | 469-630-1615
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Fax |
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Authorized Official
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Title or Position | OWNER AND THERAPIST
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Name | DR. SHANNON R LOLLAR
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Credential | PHD, LPC, LCPC, NCC
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Telephone | 361-446-0602
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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 |
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License Number State |
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