Provider Demographics
NPI:1992905350
Name:KAHN, JESSICA FALIK (MSOT)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:FALIK
Last Name:KAHN
Suffix:
Gender:F
Credentials:MSOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8370 MEADOWVIEW CT
Mailing Address - Street 2:B-22
Mailing Address - City:PARK CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84098-4672
Mailing Address - Country:US
Mailing Address - Phone:435-659-1746
Mailing Address - Fax:
Practice Address - Street 1:1910 PROSPECTOR AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84060-7211
Practice Address - Country:US
Practice Address - Phone:435-659-1746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-23
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6267199-4201225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics