Healthcare Provider Details

I. General information

NPI: 1942152020
Provider Name (Legal Business Name): WHOLESELF SYNERGETIC THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2026
Last Update Date: 02/11/2026
Certification Date: 02/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6911 N 11000 E
LAPOINT UT
84039
US

IV. Provider business mailing address

HC 67 BOX 3
LAPOINT UT
84039-9706
US

V. Phone/Fax

Practice location:
  • Phone: 435-219-5873
  • Fax:
Mailing address:
  • Phone: 435-219-5873
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LOUISE WARBURTON
Title or Position: OWNER
Credential: WARBURTON
Phone: 435-219-5873