Provider Demographics
NPI:1093404162
Name:LAMBERT, KAYLEEN MARCHANT
Entity Type:Individual
Prefix:MRS
First Name:KAYLEEN
Middle Name:MARCHANT
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1257 W MARGARET VIEW CIR
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:UT
Mailing Address - Zip Code:84065-4017
Mailing Address - Country:US
Mailing Address - Phone:385-219-6827
Mailing Address - Fax:
Practice Address - Street 1:205 E 400 S
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84058-6311
Practice Address - Country:US
Practice Address - Phone:801-426-6624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11351667-4202224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant