Healthcare Provider Details

I. General information

NPI: 1164326732
Provider Name (Legal Business Name): RISING PEAKS SPEECH THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1430 24TH ST
OGDEN UT
84401-2904
US

IV. Provider business mailing address

1430 24TH ST
OGDEN UT
84401-2904
US

V. Phone/Fax

Practice location:
  • Phone: 661-400-6269
  • Fax:
Mailing address:
  • Phone: 661-400-6269
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL

VIII. Authorized Official

Name: BRIANNA STODGELL
Title or Position: SPEECH LANGUAGE PATHOLOGIST
Credential: CCC-SLP
Phone: 661-400-6269