Healthcare Provider Details

I. General information

NPI: 1952231078
Provider Name (Legal Business Name): ANNETTE WINTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 E 4500 S STE A34
MURRAY UT
84107-2710
US

IV. Provider business mailing address

3164 S SCOTTSDALE DR
WEST VALLEY CITY UT
84120-2136
US

V. Phone/Fax

Practice location:
  • Phone: 801-771-0273
  • Fax: 801-771-0221
Mailing address:
  • Phone: 801-864-4496
  • 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: