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NPI Code Detail

MEDICARE: KACIE PREYSZ OT

MEDICARE: KACIE PREYSZ OT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist9363268-4201UT

General Provider Information

NPI Number : 1235423591
Entity Type Code : Individual
Provider Name (Legal Business Name) : KACIE PREYSZ OT
Provider Business Mailing Address
First Line : 13887 S CROMWELL LN
Second Line :
City : DRAPER
State : UT
Zip : 84020-9206
Country : US
Telephone Number : 423-930-3782
Fax Number :
Provider Business Practice Location Address
First Line : 18406 W WHITE QUEST DR
Second Line :
City : EAGLE MOUNTAIN
State : UT
Zip : 84013-9701
Country : US
Telephone Number : 801-335-4699
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2011
Last Update Date : 04/06/2020

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