Provider Demographics
NPI:1578006383
Name:GILL, MEGHAN (PHD)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:GILL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11035
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59904-4035
Mailing Address - Country:US
Mailing Address - Phone:406-282-1576
Mailing Address - Fax:406-282-1576
Practice Address - Street 1:40 2ND ST E STE 230
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-6114
Practice Address - Country:US
Practice Address - Phone:406-282-1576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-28
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1995103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist