Provider Demographics
NPI:1891869442
Name:BJORNSON, ANNIE DEE (OTRL)
Entity Type:Individual
Prefix:MS
First Name:ANNIE
Middle Name:DEE
Last Name:BJORNSON
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:ANNIE
Other - Middle Name:DEE
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTRL
Mailing Address - Street 1:719 EAST RAMONA AVENUE
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84105
Mailing Address - Country:US
Mailing Address - Phone:801-842-3981
Mailing Address - Fax:
Practice Address - Street 1:451 BISHOP FEDERAL LANE
Practice Address - Street 2:CHRISTUS ST JOSEPHS VILLA
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84115
Practice Address - Country:US
Practice Address - Phone:801-493-8903
Practice Address - Fax:801-468-6843
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant