Jennifer M Bangs, OTD OTR L

Individual provider Active NPI Occupational Therapist · Bountiful, UT

NPI 1871667451 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1871667451
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
5927273-4201 (UT)
Practice address
401 S 400 E
Mountain Land Rehabilitation
Bountiful, UT 84010-4933
Phone
(801) 397-8154
Fax
(801) 397-8051
NPI assigned
Nov 17, 2006
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

LicenseStateTypeSpecialty
5927273-4201UTMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5927273-4201 UT Yes

Addresses

Primary practice location

401 S 400 E
Mountain Land Rehabilitation
Bountiful, UT 84010-4933

Mailing address

401 S 400 E
Mountain Land Rehabilitation
Bountiful, UT 84010-4933
Phone (801) 397-8154

Other identifiers

IdentifierTypeStateIssuer
D5312MedicaidUT

Other providers in Bountiful, UT

All providers in Bountiful, UT · Occupational Therapist in Utah

Sources for this page

Verify at the official NPI Registry.