Individual
SANDRA R BEVERLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
18406 W WHITE QUEST DR, EAGLE MOUNTAIN, UT 84013-9701
(217) 891-7466
Mailing address
18406 W WHITE QUEST DR, EAGLE MOUNTAIN, UT 84013-9701
(303) 840-6374
(303) 374-8290
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT.0005359
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1740786250
—
CO
Enumeration date
04/03/2018
Last updated
04/06/2020
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