IndividualActive
Ann Wallace, OTR/L
NPI 1710240635 · Occupational Therapist · Salt Lake City, UT
Provider details
- NPI number
- 1710240635
- Entity type
- Individual
- Primary specialty
- Occupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- OTR/L
- Sex
- Female
- Sole proprietor
- Yes
- License
- 8336770-4201 (UT)
Practice location
1138 E Wilmington Ave
Salt Lake City, UT 84106-2819
Phone: (801) 581-2221
Mailing address
Po Box 511258
Los Angeles, CA 90051-7813
Registry dates
- Enumerated
- 2012-06-18
- Last updated
- 2022-02-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.