Healthcare Provider Details

I. General information

NPI: 1609731538
Provider Name (Legal Business Name): TRESSA O'CONNER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/23/2025
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 E FORT UNION BLVD
MIDVALE UT
84047-1531
US

IV. Provider business mailing address

875 E ARROWHEAD LN UNIT 19
MURRAY UT
84107-5621
US

V. Phone/Fax

Practice location:
  • Phone: 801-654-0772
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: