MEDICARE: LAURA C. LOPACH PH.D.,

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	PSY-PSY-2844	MT

General Provider Information

NPI Number	:	1467704775
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA C. LOPACH PH.D.,

Provider Business Mailing Address
First Line	:	1821 SOUTH AVE W STE 400
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59801-6521
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1821 SOUTH AVE W STE 400
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59801-6521
Country	:	US
Telephone Number	:	406-209-8905
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2012
Last Update Date	:	12/17/2025

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