Provider Demographics
NPI:1699222554
Name:STROH, ANNA
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:STROH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 NOGALES WAY
Mailing Address - Street 2:APT 304
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82716-2353
Mailing Address - Country:US
Mailing Address - Phone:307-760-2587
Mailing Address - Fax:
Practice Address - Street 1:2300 WILSON ST
Practice Address - Street 2:
Practice Address - City:MILES CITY
Practice Address - State:MT
Practice Address - Zip Code:59301-5078
Practice Address - Country:US
Practice Address - Phone:307-760-2587
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-07
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTOTP-OT--LIC-4642225X00000X
225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist