Healthcare Provider Details

I. General information

NPI: 1427659895
Provider Name (Legal Business Name): SONIA ROBERTS AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2020
Last Update Date: 12/31/2025
Certification Date: 12/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13552 S 110 W STE 204
DRAPER UT
84020-2403
US

IV. Provider business mailing address

12222 S 1000 E STE 3
DRAPER UT
84020-3203
US

V. Phone/Fax

Practice location:
  • Phone: 801-432-0883
  • Fax:
Mailing address:
  • Phone: 801-432-0883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number14244668-3904
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: