MEDICARE: MRS. SUZANNE ZIBETTI OTR

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
1	225X00000X	Occupational Therapist	102612-4201	UT

General Provider Information

NPI Number	:	1912835042
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SUZANNE ZIBETTI OTR

Provider Business Mailing Address
First Line	:	1388 N GENEVA RD
Second Line	:
City	:	PROVO
State	:	UT
Zip	:	84601-1287
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1190 W 900 N
Second Line	:
City	:	PROVO
State	:	UT
Zip	:	84604-3171
Country	:	US
Telephone Number	:	801-437-3100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2026
Last Update Date	:	05/11/2026

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