Individual
DESTANI AMANDA ORTIZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
U
Contact information
Practice address
50 E 9000 S, SANDY, UT 84070-2201
(801) 561-9839
Mailing address
3588 S 4200 W APT A3, WEST VALLEY CITY, UT 84120-3272
(801) 971-9278
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
1392825-4003
UT
Other
Enumeration date
05/24/2024
Last updated
05/24/2024
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