Healthcare Provider Details

I. General information

NPI: 1679934392
Provider Name (Legal Business Name): HARMONY SPENCER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2016
Last Update Date: 03/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

87 W 600 S
MT PLEASANT UT
84647-1902
US

IV. Provider business mailing address

87 W 600 S
MT PLEASANT UT
84647-1902
US

V. Phone/Fax

Practice location:
  • Phone: 435-851-2992
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: