Healthcare Provider Details

I. General information

NPI: 1558003459
Provider Name (Legal Business Name): TAYLOR CORDOVA LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2022
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

831 E 340 S STE 110
AMERICAN FORK UT
84003-3329
US

IV. Provider business mailing address

1933 N 1120 W
PROVO UT
84604-1044
US

V. Phone/Fax

Practice location:
  • Phone: 801-683-6830
  • Fax:
Mailing address:
  • Phone: 801-683-6830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number12849298-3904
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: