Individual
JESSICA MORTENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
575 CUTLER DR, NORTH SALT LAKE, UT 84054-2953
(801) 936-0318
Mailing address
575 CUTLER DR, NORTH SALT LAKE, UT 84054-2953
(801) 936-0318
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
8384965-4202
UT
Other
Enumeration date
12/09/2022
Last updated
12/09/2022
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