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General NPI Number Information
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NPI Number | 1225971880
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Entity Type | Individual
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Provider Name | JILLIAN BRINTON COTA/L
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Gender | Female
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Dates
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Enumeration Date | 04/09/2026
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Last Update Date | 04/09/2026
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Provider Practice Location Address
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Address Line | 4782 S HOLLADAY BLVD
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City | HOLLADAY
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State | UT
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Zip | 84117-5444
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Country | US
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Telephone | 801-277-7002
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Fax |
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Provider Business Mailing Address
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Address Line | 4765 S MEADOW VIEW RD
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City | MURRAY
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State | UT
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Zip | 84107-3964
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Country | US
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Telephone | 801-889-5683
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 13479823-4202
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License Number State | UT
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