Individual
SHELBY STAKER TRUJILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2500 S STATE ST, SOUTH SALT LAKE, UT 84115-3164
(385) 646-5000
Mailing address
1272 W DUSTY DOWNS CIR, SOUTH JORDAN, UT 84095-8243
(801) 703-6105
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
6810854-4202
UT
Other
Enumeration date
05/06/2022
Last updated
05/06/2022
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