Ana Cleia Miranda Walker
Individual provider Active NPI Recreation Therapist · Kanab, UT
NPI 1619716974 · NPPES record last updated May 24, 2024
Key facts
- NPI
- 1619716974
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Recreation Therapist 225800000X
- License
- 13368257-4003 (UT)
- Practice address
- 355 N Main St
Kanab, UT 84741-3260 - Phone
- (435) 644-5811
- NPI assigned
- May 24, 2024
- 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 |
|---|---|---|---|
| 13368257-4003 | UT | MD | Recreation Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Recreation Therapist | 225800000X | 13368257-4003 | UT | Yes |
Addresses
Primary practice location
355 N Main St
Kanab, UT 84741-3260
Mailing address
6178 Antelope TRL
Kanab, UT 84741-4107
Phone (435) 272-2655
Other providers in Kanab, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 24, 2024. 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.