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Individual

SANDRIA STUBBS WILDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5320 ADAMS AVE PKWY, OGDEN, UT 84405-6913
(801) 476-7800
Mailing address
871 E HEARTWOOD CIR, FRUIT HEIGHTS, UT 84037-2142

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
9066168-4202
UT

Other

Enumeration date
11/15/2022
Last updated
11/15/2022
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