MEDICARE: THE INTENTIONAL OT LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1699584185
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE INTENTIONAL OT LLC

Provider Business Mailing Address
First Line	:	270 BLACKBERRY LOOP UNIT B
Second Line	:
City	:	WHITEFISH
State	:	MT
Zip	:	59937-7993
Country	:	US
Telephone Number	:	406-290-9373
Fax Number	:

Provider Business Practice Location Address
First Line	:	535 4TH AVE W
Second Line	:
City	:	COLUMBIA FALLS
State	:	MT
Zip	:	59912-3605
Country	:	US
Telephone Number	:	406-290-9373
Fax Number	:

Authorized Official
Title or Position	:	OWNER OPERATOR
Name	:	HEIDI FLETCHER
Credential	:	MOT, OTR/L
Telephone Number	:	406-290-9373

Provider Enumeration Date	:	12/30/2024
Last Update Date	:	10/07/2025

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