Healthcare Provider Details

I. General information

NPI: 1417762162
Provider Name (Legal Business Name): SARAH MIKESELL OT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2025
Last Update Date: 02/10/2025
Certification Date: 02/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 S MEDICAL DR
MT PLEASANT UT
84647-2200
US

IV. Provider business mailing address

150 W 300 S
EPHRAIM UT
84627-1351
US

V. Phone/Fax

Practice location:
  • Phone: 435-274-3533
  • Fax:
Mailing address:
  • Phone: 623-986-0526
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number14204814-4201
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: