NPI 1174498109

Summer Alyse Broeker

Practitioner Recreation Therapist Provo, UT

Practice location

Address: 1001 N 500 W, Provo, UT 84604-3305
Phone: (801) 377-9661
Mailing address: 724 S 1700 W, Payson, UT 84651-5747

Registered specialties

Recreation Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225800000X Licence 14245436-4003 (UT)

Other Recreation Therapist providers in Utah →

Registry record

NPI: 1174498109
Entity type: Individual
Sex (as registered): Female
NPI issued: 8 Oct 2025
Record last updated: 8 Oct 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.