Healthcare Provider Details

I. General information

NPI: 1831022631
Provider Name (Legal Business Name): LAUREN BISHOP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

372 W GORDON AVE
LAYTON UT
84041-4485
US

IV. Provider business mailing address

568 S 925 E
LAYTON UT
84041-4485
US

V. Phone/Fax

Practice location:
  • Phone: 801-452-1940
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: