Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 80464043-4201 | UT |
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 8046043-4201 | UT |
NPI | 1578971578 |
---|---|
Provider Name | Allison Merrell |
First Address | Park City, UT 84060-7552 |
Second Address | Park City, UT 84060-7552 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2014 |
Last Update Date | 08/02/2019 |