Individual
SHANNA LEE STACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3031 S RUSSELL ST STE B, MISSOULA, MT 59801-8523
(406) 396-4130
(406) 797-5008
Mailing address
3031 S RUSSELL ST STE B, MISSOULA, MT 59801-8523
(406) 396-4130
(406) 797-5008
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-SP-TMP-3159
MT
Other
Enumeration date
07/24/2013
Last updated
12/22/2022
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