Healthcare Provider Details

I. General information

NPI: 1225942550
Provider Name (Legal Business Name): SHIVANGI UMESH PATEL OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

347 LAMPLIGHTER LN
GREAT FALLS MT
59405-4172
US

IV. Provider business mailing address

347 LAMPLIGHTER LN
GREAT FALLS MT
59405-4172
US

V. Phone/Fax

Practice location:
  • Phone: 847-894-6214
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberPRD-OT-LIC-9550
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: