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Individual

MRS. MONA HIBBERT AGAMEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
90 W 500 S # 315, BOUNTIFUL, UT 84010-6230
(702) 499-3841
(877) 296-8903
Mailing address
90 W 500 S # 315, BOUNTIFUL, UT 84010-6230
(702) 499-3841
(877) 296-8903

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0470
NV
225XP0200X
Pediatric Occupational Therapist
0470
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003402366
NV
Enumeration date
11/01/2006
Last updated
07/09/2013
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