Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 283963-4202 | UT |
NPI | 1013563956 |
---|---|
Provider Name | Sherri Renee Hatfield |
First Address | Taylorsville, UT 84123-3670 |
Second Address | Taylorsville, UT 84123-3670 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2019 |
Last Update Date | 15/08/2019 |