Individual
JANA LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
355 E 200 N, NEPHI, UT 84648-1535
(801) 389-9422
Mailing address
355 E 200 N, NEPHI, UT 84648-1535
(801) 389-9422
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
10881015-4202
UT
Other
Enumeration date
09/26/2022
Last updated
09/26/2022
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