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NPI Code Detail

MEDICARE: JESSICA O'BRIEN MOT,OTR/L

MEDICARE:   JESSICA  O'BRIEN  MOT,OTR/L
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
1225700000XMassage Therapist14095043-4701UT
2225X00000XOccupational Therapist8395470-4201UT

General Provider Information

NPI Number : 1902462765
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA O'BRIEN MOT,OTR/L
Provider Business Mailing Address
First Line : 4027 S CASTLE VIEW DR
Second Line :
City : WEST VALLEY CITY
State : UT
Zip : 84128-4267
Country : US
Telephone Number : 435-938-1698
Fax Number : 940-383-1251
Provider Business Practice Location Address
First Line : 4027 S CASTLE VIEW DR
Second Line :
City : WEST VALLEY CITY
State : UT
Zip : 84128-4267
Country : US
Telephone Number : 435-938-1698
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2019
Last Update Date : 08/07/2024

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Directions to “ JESSICA O'BRIEN MOT,OTR/L” Practice Location

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