Individual
MRS. SUSAN J HAGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
(801) 581-2121
Mailing address
PO BOX 510721, SALT LAKE CITY, UT 84151-0721
(801) 587-6872
(801) 587-6675
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
953100164201
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31001642000001
BLUE CROSS BLUE SHIELD ID
UT
Enumeration date
08/30/2006
Last updated
12/02/2021
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