Individual
MIA MORTENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
TRS, CTRS
Contact information
Practice address
500 FOOTHILL DR, SALT LAKE CITY, UT 84148-0001
(801) 637-8355
Mailing address
500 FOOTHILL DR, SALT LAKE CITY, UT 84148-0001
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
—
—
Other
Enumeration date
03/29/2022
Last updated
03/29/2022
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