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General NPI Number Information
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NPI Number | 1699584185
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Entity Type | Organization
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Legal Business Name | THE INTENTIONAL OT LLC
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Dates
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Enumeration Date | 12/30/2024
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 535 4TH AVE W
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City | COLUMBIA FALLS
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State | MT
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Zip | 59912-3605
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Country | US
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Telephone | 406-290-9373
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Fax |
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Provider Business Mailing Address
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Address Line | 270 BLACKBERRY LOOP UNIT B
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City | WHITEFISH
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State | MT
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Zip | 59937-7993
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Country | US
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Telephone | 406-290-9373
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Fax |
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Authorized Official
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Title or Position | OWNER OPERATOR
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Name | HEIDI FLETCHER
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Credential | MOT, OTR/L
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Telephone | 406-290-9373
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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