Angela Blaser, OTR/L
Individual provider Active NPI Occupational Therapist · Provo, UT
NPI 1124784343 · NPPES record last updated Apr 4, 2022
Key facts
- NPI
- 1124784343
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 11291405-4201 (UT)
- Practice address
- 750 N Freedom Blvd
Provo, UT 84601-1677 - Phone
- (801) 373-4760
- NPI assigned
- Nov 11, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11291405-4201 | UT | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 11291405-4201 | UT | Yes |
Addresses
Primary practice location
750 N Freedom Blvd
Provo, UT 84601-1677
Mailing address
750 N Freedom Blvd
Provo, UT 84601-1677
Phone (801) 373-4760
Other providers in Provo, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 4, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.