Individual
NELLIE BUBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3723 W 12600 S, RIVERTON, UT 84065-7295
(833) 577-3422
Mailing address
9703 S KALINA WAY #3-201, SANDY, UT 84092
(612) 719-7863
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
11318297-4201
UT
Other
Enumeration date
08/01/2019
Last updated
08/01/2019
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