Individual
HALEY BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2639 W 3520 S, WEST HAVEN, UT 84401-8529
(801) 732-5290
Mailing address
66 E DORCHESTER DR, SALT LAKE CITY, UT 84103-2203
(801) 884-9569
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
13708203-4201
UT
Other
Enumeration date
02/28/2024
Last updated
02/28/2024
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