Individual
MRS. CONNIE C CARR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
365 W 1550 N, LAYTON, UT 84041-6888
(801) 618-7903
Mailing address
11392 S SKYLUX AVE, SOUTH JORDAN, UT 84009-5047
(801) 870-0354
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
11873192-4202
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1578082954
NPIII
UT
Enumeration date
08/26/2020
Last updated
08/26/2020
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