Provider Demographics
NPI:1245921808
Name:NETHERCOTT, BRITTNEY (OTR/L)
Entity type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:
Last Name:NETHERCOTT
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 E 400 S
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:UT
Mailing Address - Zip Code:84335-1350
Mailing Address - Country:US
Mailing Address - Phone:307-248-8358
Mailing Address - Fax:
Practice Address - Street 1:248 W 300 N
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84321-3810
Practice Address - Country:US
Practice Address - Phone:435-752-0411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13333032-4201225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist