Healthcare Provider Details

I. General information

NPI: 1346102837
Provider Name (Legal Business Name): MEGAN ELIZABETH JUDD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2025
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

237 W 520 N
OREM UT
84057-4696
US

IV. Provider business mailing address

237 W 520 N
OREM UT
84057-4696
US

V. Phone/Fax

Practice location:
  • Phone: 801-642-4244
  • Fax:
Mailing address:
  • Phone: 801-642-4244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number9846239-6004
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: