Provider Demographics
NPI:1114722105
Name:WINNETT, ANNIKA (OTR)
Entity type:Individual
Prefix:
First Name:ANNIKA
Middle Name:
Last Name:WINNETT
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 N LAST CHANCE GULCH STE 8
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-4158
Mailing Address - Country:US
Mailing Address - Phone:406-439-0090
Mailing Address - Fax:406-391-7112
Practice Address - Street 1:44 N LAST CHANCE GULCH STE 8
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-4158
Practice Address - Country:US
Practice Address - Phone:406-439-0090
Practice Address - Fax:406-391-7112
Is Sole Proprietor?:No
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTOTP-OT-LIC-11657225X00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist