Individual
MADELYN PAIGE ELLSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
50 N MEDICAL DR # 4, SALT LAKE CITY, UT 84132-5809
(801) 581-2132
Mailing address
50 N MEDICAL DR # 4, SALT LAKE CITY, UT 84132-0001
(801) 987-6333
(801) 373-0639
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
12902170-4201
UT
225XP0200X
Pediatric Occupational Therapist
—
—
Other
Enumeration date
04/08/2014
Last updated
03/04/2024
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