Healthcare Provider Details

I. General information

NPI: 1417667494
Provider Name (Legal Business Name): MARCEL DRANSFIELD OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARCIE DRANSFIELD GRAVES OTR/L

II. Dates (important events)

Enumeration Date: 11/30/2022
Last Update Date: 11/30/2022
Certification Date: 11/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

665 CUTLER DR
NORTH SALT LAKE UT
84054-2970
US

IV. Provider business mailing address

1163 E CHARLTON AVE
SALT LAKE CITY UT
84106-2603
US

V. Phone/Fax

Practice location:
  • Phone: 801-936-0318
  • Fax:
Mailing address:
  • Phone: 858-598-7501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number9129368-4201
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: