Provider Demographics
NPI:1528128840
Name:HASKINS, RITA A (OT)
Entity type:Individual
Prefix:
First Name:RITA
Middle Name:A
Last Name:HASKINS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 LOST CREEK DR
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-7012
Mailing Address - Country:US
Mailing Address - Phone:406-253-9219
Mailing Address - Fax:
Practice Address - Street 1:660 LOST CREEK DR
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-7012
Practice Address - Country:US
Practice Address - Phone:406-253-9219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT364225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT66085OtherBLUE CROSS
MT347529Medicaid
MT5605041Medicaid