Healthcare Provider Details

I. General information

NPI: 1144843905
Provider Name (Legal Business Name): ALEXIS EGAN OTD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2020
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 AVENUE E STE A
BILLINGS MT
59102-2943
US

IV. Provider business mailing address

1701 AVENUE E STE A
BILLINGS MT
59102-2943
US

V. Phone/Fax

Practice location:
  • Phone: 406-690-6996
  • Fax: 406-206-5262
Mailing address:
  • Phone: 406-690-6996
  • Fax: 406-206-5262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOTP-OT-LIC-11665
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: