Healthcare Provider Details

I. General information

NPI: 1467623017
Provider Name (Legal Business Name): SUSAN HORN OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2008
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2224 E 3205 S
SALT LAKE CITY UT
84109-2615
US

IV. Provider business mailing address

2224 E 3205 S
SALT LAKE CITY UT
84109-2615
US

V. Phone/Fax

Practice location:
  • Phone: 801-231-9207
  • Fax: 801-290-2866
Mailing address:
  • Phone: 801-231-9207
  • Fax: 801-290-2866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5629747-4201
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: