Healthcare Provider Details

I. General information

NPI: 1851221741
Provider Name (Legal Business Name): LISA HANSEN THOMPSON RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3006 S HIGHLAND DR STE 210
MILLCREEK UT
84106-6004
US

IV. Provider business mailing address

3006 S HIGHLAND DR STE 210
MILLCREEK UT
84106-6004
US

V. Phone/Fax

Practice location:
  • Phone: 801-647-3920
  • Fax: 801-931-2607
Mailing address:
  • Phone: 801-647-3920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: