Healthcare Provider Details

I. General information

NPI: 1770312464
Provider Name (Legal Business Name): COURTNEY FLINT OTD/ OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2024
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 N MEDICAL DR
SALT LAKE CITY UT
84112-1100
US

IV. Provider business mailing address

1111 E BRICKYARD RD APT 533
SALT LAKE CITY UT
84106-4443
US

V. Phone/Fax

Practice location:
  • Phone: 801-587-3422
  • Fax:
Mailing address:
  • Phone: 402-270-9145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number14061783-4201
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: