Provider Demographics
NPI:1497506232
Name:FRANDSEN, KYLIE (MOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:KYLIE
Middle Name:
Last Name:FRANDSEN
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 S WOOD STREAM RD
Mailing Address - Street 2:
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-4303
Mailing Address - Country:US
Mailing Address - Phone:817-703-6943
Mailing Address - Fax:
Practice Address - Street 1:401 S 400 E
Practice Address - Street 2:
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-4933
Practice Address - Country:US
Practice Address - Phone:801-295-2361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13847945-4201225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist