Healthcare Provider Details

I. General information

NPI: 1972660835
Provider Name (Legal Business Name): PAULA HUBER KITZENBERG OTRL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3510 TIMBERLINE DR
BILLINGS MT
59102-0349
US

IV. Provider business mailing address

3510 TIMBERLINE DR
BILLINGS MT
59102-0349
US

V. Phone/Fax

Practice location:
  • Phone: 406-690-3523
  • Fax: 406-652-3798
Mailing address:
  • Phone: 406-690-3523
  • Fax: 406-652-3798

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number315
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: