Healthcare Provider Details

I. General information

NPI: 1164888962
Provider Name (Legal Business Name): JUDITH CARRIGAN OT/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2016
Last Update Date: 02/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7500 PRIEST PASS RD
HELENA MT
59601-9666
US

IV. Provider business mailing address

7500 PRIEST PASS RD
HELENA MT
59601-9666
US

V. Phone/Fax

Practice location:
  • Phone: 406-431-4628
  • Fax:
Mailing address:
  • Phone: 406-431-4628
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOTP-OT-LIC-273
License Number StateMT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: