Healthcare Provider Details

I. General information

NPI: 1942923248
Provider Name (Legal Business Name): GAILIA ANN LARA LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. GAILIA ANN BEGAY

II. Dates (important events)

Enumeration Date: 09/21/2022
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5965 S 900 E STE 100
MURRAY UT
84121-1850
US

IV. Provider business mailing address

245 E GORDON LN APT 21
MILLCREEK UT
84107-3102
US

V. Phone/Fax

Practice location:
  • Phone: 801-872-5516
  • Fax: 801-212-9942
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number14195871-3501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: