Individual
EMILY BURDITT
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
(801) 355-4699
(801) 355-7031
Mailing address
255 S UNIVERSITY AVE APT A410, PROVO, UT 84601-4498
(903) 771-8451
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
11544970-4201
UT
225X00000X
Occupational Therapist
118976
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
118976
TBOTE
TX
Enumeration date
08/28/2019
Last updated
08/24/2021
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