Healthcare Provider Details

I. General information

NPI: 1841316593
Provider Name (Legal Business Name): ARIEN NICOLE MCOMBER M.A., MOT, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 11/29/2021
Certification Date: 11/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5121 S COTTONWOOD STREET IMC
MURRAY UT
84107
US

IV. Provider business mailing address

930 E ATKIN AVE
SALT LAKE CITY UT
84106-2234
US

V. Phone/Fax

Practice location:
  • Phone: 801-807-7457
  • Fax:
Mailing address:
  • Phone: 253-278-0813
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number7062414-4201
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: