Individual
MRS. KATIE R CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
331 N 400 W, OREM, UT 84057-1913
(801) 224-4080
(801) 226-7831
Mailing address
PO BOX 30180, SALT LAKE CITY, UT 84130-0180
(801) 357-7475
(801) 357-7997
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
59297044201
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
529297044201
UTAH STATE LICENSE
UT
Enumeration date
07/27/2006
Last updated
07/08/2007
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