ELLISON KRUCKENBERG, COTA/L
Occupational Therapy Assistant
Active
Individual
NPI: 1386100402
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | Yes | 12931092-4202 (UT) |
Frequently Asked Questions
NPI 1386100402 is the National Provider Identifier for ELLISON KRUCKENBERG, COTA/L, a Occupational Therapy Assistant provider located in Bountiful, UT. This NPI was enumerated on February 13, 2019.
ELLISON KRUCKENBERG, COTA/L practices at 401 S 400 E, Bountiful, UT 84010.
Quick Facts
- NPI
- 1386100402
- Type
- Individual
- Enumerated
- Feb 13, 2019
- Last Updated
- Jul 12, 2022
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