Individual
KACEY LEE SHIVELEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3741 W 12600 S STE 100, RIVERTON, UT 84065-7215
(833) 577-3422
Mailing address
PO BOX 30180, SALT LAKE CITY, UT 84130-0180
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
13446577-4201
UT
Other
Enumeration date
06/13/2023
Last updated
10/31/2024
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