Healthcare Provider Details

I. General information

NPI: 1861360315
Provider Name (Legal Business Name): HAYDEN DAYLE ALLEN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2025
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 E 770 N
OREM UT
84097-4101
US

IV. Provider business mailing address

1439 S 465 W
OREM UT
84058-7389
US

V. Phone/Fax

Practice location:
  • Phone: 385-412-9880
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number14235972-6009
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: