Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Legendary Pediatric Therapy

Organization Occupational Therapist · NPI 1568869899

Legendary Pediatric Therapy is an Occupational Therapist in Draper, Utah. Licensed in Utah. Registered with an NPI since 2014.

Licensed in
UT
In the registry since
2014
Specialties on file
3

Practice location Address checks out

12453 S 265 W Ste B
Draper, UT 84020-5420
Phone: (801) 443-7775
Fax: (801) 447-0107
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 6717450-4201 (UT)
Occupational Therapist Taxonomy 225X00000X · Licence 5044485-4201 (UT)
Speech-Language Pathologist Taxonomy 235Z00000X · Licence 9554558-4102 (UT)

Record details

NPI number1568869899
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Breeann Millette — Billing Manager · (801) 443-7775
Other names Functionabilities; Functionabilities
NPI enumeratedDecember 2, 2014
Last updated in NPPESApril 9, 2026
Certification dateApril 9, 2026
Mailing address12453 S 265 W Ste B, Draper, UT 84020-5420

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