Healthcare Provider Details

I. General information

NPI: 1295646453
Provider Name (Legal Business Name): THE HEALING BURROW
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6975 UNION PARK AVE SUITE 600
COTTONWOOD HEIGHTS UT
84047
US

IV. Provider business mailing address

131 E 2600 S
CLEARFIELD UT
84015-1951
US

V. Phone/Fax

Practice location:
  • Phone: 801-608-9966
  • Fax:
Mailing address:
  • Phone: 801-608-9966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: JENNIFER POULOS
Title or Position: LCSW
Credential:
Phone: 801-608-9966