Healthcare Provider Details

I. General information

NPI: 1811891872
Provider Name (Legal Business Name): MIRIAM GUNN - COACHING & FAMILY THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

139 S 400 E
HYDE PARK UT
84318-3543
US

IV. Provider business mailing address

139 S 400 E
HYDE PARK UT
84318-3543
US

V. Phone/Fax

Practice location:
  • Phone: 435-770-6025
  • Fax:
Mailing address:
  • Phone: 435-770-6025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: MIRIAM GUNN
Title or Position: OWNER / THERAPIST
Credential: LMFT
Phone: 435-770-6025