Individual
THERESA ANN GOLLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.T.D.
Contact information
Practice address
3845 W 4700 S, TAYLORSVILLE, UT 84118-3454
(801) 840-4360
(801) 840-4399
Mailing address
1144 SANDTRAP CIR, N SALT LAKE, UT 84054-3324
(801) 558-7050
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
6604772-4201
UT
Other
Enumeration date
03/06/2009
Last updated
03/06/2009
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