Individual
AMANDA WEIGLE NELLEMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
8TH AVE C ST, SALT LAKE CITY, UT 84143-4220
(801) 408-1100
Mailing address
8963 DAYBREAKER DR, PARK CITY, UT 84098-5819
(813) 446-5257
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
113212
TX
225X00000X
Occupational Therapist
OT 13076
FL
225XG0600X
Gerontology Occupational Therapist
Primary
7261
NC
Other
Enumeration date
11/18/2009
Last updated
11/09/2021
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