Individual provider · Type 1 NPI

Ellison M. Kruckenberg, COTA/L

Occupational Therapy Assistant · Bountiful, UT

NPI number 1386100402 Active

Practice location

401 S 400 E
Bountiful, UT 84010-4933

Call (801) 295-2361 Map

Mailing address

9487 S Wasatch Downs Cir
South Jordan, UT 84095-9289

Specialties and licenses

TaxonomyCodeLicense
Occupational Therapy Assistant Primary 224Z00000X12931092-4202 (UT)

Occupational Therapy Assistant: An occupational therapy assistant is a person who has graduated from an occupational therapy assistant program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, has successfully completed a period of supervised fieldwork experience required by the accredited occupational therapy assistant program, has passed a nationally recognized entry-level examinatio…

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About NPI 1386100402

Ellison M. Kruckenberg, COTA/L's National Provider Identifier is 1386100402, issued on Feb 13, 2019. The primary taxonomy on file is Occupational Therapy Assistant (224Z00000X), and the practice location is in Bountiful, UT. The record was last updated on Jul 12, 2022.