Healthcare Provider Details

I. General information

NPI: 1073437067
Provider Name (Legal Business Name): CHELSEA ANN OLIVER MTRC, CTRS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13939 S CANAAN PEAK DR
HERRIMAN UT
84096-2956
US

IV. Provider business mailing address

13939 S CANAAN PEAK DR
HERRIMAN UT
84096-2956
US

V. Phone/Fax

Practice location:
  • Phone: 801-916-5921
  • Fax:
Mailing address:
  • Phone: 801-916-5921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225800000X
TaxonomyRecreation Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: