Individual
MIRANDA BERCHTOLD IPSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
4401 HARRISON BLVD, OGDEN, UT 84403-3195
(801) 387-2800
Mailing address
4401 HARRISON BLVD, OGDEN, UT 84403-3195
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
13430993-4201
UT
Other
Enumeration date
11/30/2023
Last updated
11/30/2023
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