Healthcare Provider Details

I. General information

NPI: 1225897093
Provider Name (Legal Business Name): ABBIE REEVES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2024
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 N 1050 E
BOUNTIFUL UT
84010-2943
US

IV. Provider business mailing address

2123 N 825 E
LEHI UT
84043-3363
US

V. Phone/Fax

Practice location:
  • Phone: 801-980-7970
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number14295979-2506
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: