Healthcare Provider Details

I. General information

NPI: 1851227128
Provider Name (Legal Business Name): BALANCED THERAPY & NUTRITION PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13299 S ASHWOOD GLEN WAY
DRAPER UT
84020-7132
US

IV. Provider business mailing address

13299 S ASHWOOD GLEN WAY
DRAPER UT
84020-7132
US

V. Phone/Fax

Practice location:
  • Phone: 801-814-0518
  • Fax:
Mailing address:
  • Phone: 801-814-0518
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: KAITLIN EARL
Title or Position: CO-OWNER
Credential: RDN
Phone: 801-814-0518