Provider Demographics
NPI:1043431836
Name:SHIPSTEAD, ELIZABETH ANNE (OTRL)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANNE
Last Name:SHIPSTEAD
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:ANNE
Other - Last Name:HANSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTRL
Mailing Address - Street 1:552 FAS 438
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:MT
Mailing Address - Zip Code:59248
Mailing Address - Country:US
Mailing Address - Phone:406-781-5871
Mailing Address - Fax:
Practice Address - Street 1:552 FAS 438
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:MT
Practice Address - Zip Code:59248
Practice Address - Country:US
Practice Address - Phone:406-781-5871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT943225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist