Provider Demographics
NPI:1164888962
Name:CARRIGAN, JUDITH (OT/L)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:CARRIGAN
Suffix:
Gender:F
Credentials:OT/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7500 PRIEST PASS RD
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-9666
Mailing Address - Country:US
Mailing Address - Phone:406-431-4628
Mailing Address - Fax:
Practice Address - Street 1:7500 PRIEST PASS RD
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-9666
Practice Address - Country:US
Practice Address - Phone:406-431-4628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-08
Last Update Date:2016-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTOTP-OT-LIC-273225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics