Provider Demographics
NPI:1881468098
Name:MUNRO, JOANNA VIRGINIA (ACLC)
Entity type:Individual
Prefix:MRS
First Name:JOANNA
Middle Name:VIRGINIA
Last Name:MUNRO
Suffix:
Gender:F
Credentials:ACLC
Other - Prefix:MRS
Other - First Name:JOANNA
Other - Middle Name:VIRGINIA
Other - Last Name:DUGALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1150
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:MT
Mailing Address - Zip Code:59925-1150
Mailing Address - Country:US
Mailing Address - Phone:406-314-8168
Mailing Address - Fax:
Practice Address - Street 1:1645 US HIGHWAY 93 S
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-5775
Practice Address - Country:US
Practice Address - Phone:406-314-6565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-08
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-ACLC-LIC-64848101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)