Individual
MS. GRACIA L SCHALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS LCPC
Contact information
Practice address
1640 SOUTH AVENUE WEST, MISSOULA, MT 59801
(406) 721-1774
(406) 721-1774
Mailing address
1640 SOUTH AVE W, MISSOULA, MT 59801-7804
(406) 721-1774
(406) 721-1774
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
55 LCPC
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0257074
—
MT
01
—
075310
BLUE CROSS
MT
Enumeration date
02/10/2006
Last updated
07/09/2007
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