Provider Demographics
NPI:1417700493
Name:NAYLOR, SALLY (TRS/CTRS)
Entity Type:Individual
Prefix:
First Name:SALLY
Middle Name:
Last Name:NAYLOR
Suffix:
Gender:F
Credentials:TRS/CTRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 W 1325 N
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84721-7720
Mailing Address - Country:US
Mailing Address - Phone:435-586-6481
Mailing Address - Fax:
Practice Address - Street 1:411 W 1325 N
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84721-7720
Practice Address - Country:US
Practice Address - Phone:435-586-6481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6359951-4002225800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist